Public hospitals in China are increasingly relying on performance evaluation frameworks to enhance clinical efficiency, accountability, and service quality. However, performance metrics alone may not yield meaningful improvements if the workforce lacks adequate skills to translate institutional targets into clinical practice. This study examines the direct effect of administrative performance metrics on healthcare quality and investigates whether staff competency mediates this relationship. A structured survey was administered to healthcare professionals across Tier II and Tier III public hospitals in Beijing, Shanghai, Henan, and Guangdong, yielding 462 valid responses. Structural equation modelling indicates that performance metrics positively influence quality of care (β = 0.42, p < 0.001), while staff competency demonstrates a strong independent effect on healthcare outcomes (β = 0.63, p < 0.001). Mediation analysis further confirms that competency partially mediates the relationship between performance metrics and care quality, explaining 38% of the variance. These findings suggest that metrics become meaningful only when supported by trained, skilled staff capable of operationalizing standards. The study concludes that policy reforms should emphasize competency-building, combined with performance measurement systems, to strengthen China’s hospital quality framework.
Keywords: Performance Metrics, Staff Competency, Quality of Care, Mediation, Public Hospitals, China.
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