Electronic health records are now used by 88% of office-based physicians. Yet healthcare costs have jumped 152% in the last 20 years.
Healthcare organizations face new challenges unlike anything before. Rising costs, new technology, and changing patient needs push leaders to make informed decisions quicker than ever. Healthcare KPIs (Key Performance Indicators) are vital tools that can lead to success.
Healthcare key performance indicators are specific data points that help assess performance and guide strategic adjustments. A strong healthcare KPI should be clear, measurable, well-communicated, and significant to reach your strategic goals.
The right KPIs do more than track progress—they will give a clear path to reach your long-term objectives. These metrics, when used properly, cut down paperwork time and let your organization focus on what matters most: patient care.
This piece will show you how to create healthcare KPIs that deliver results instead of gathering dust in reports. We’ll guide you through picking the right metrics and building effective dashboards to reshape the scene of how you measure and boost performance.
What Are Key Performance Indicators in Healthcare?
Healthcare key performance indicators (KPIs) work like vital signs for your organization. These measurable values show how well your healthcare system achieves specific objectives [1]. KPIs are not just regular metrics. They are carefully picked measurements that connect directly to your strategic goals and day-to-day priorities.
KPIs turn raw data into analytical insights that guide action [2]. They simplify complex information into clear signals about your organization’s direction. Healthcare leaders use these indicators as management tools to plan, set priorities, make decisions, and solve problems quickly [1].
Categories of Healthcare KPIs
Healthcare KPIs fit into several distinct categories:
- Operational Efficiency: Metrics like patient wait times and resource utilization
- Financial Health: Revenue cycle metrics, cost per discharge, profit margins
- Clinical Quality: Treatment outcomes, readmission rates
- Patient Safety: Infection rates, medication errors
- Public Health Outcomes: Population health metrics [1]
Research shows different ways to classify KPIs. Some experts group them into operational, tactical, and strategic indicators. Others sort them by performance dimensions like safety, effectiveness, efficiency, timeliness, patient-centeredness, and equity [1].
Purpose and Effect of Healthcare KPIs
Well-implemented healthcare KPIs lead to meaningful improvements throughout your organization. They help you:
Track quality of care, satisfaction, and safety metrics to boost patient outcomes [1]. Regular monitoring of these indicators reveals whether your objectives are achievable and to what extent [1].
Streamline processes and improve service delivery for better operational efficiency. Internal process indicators proved especially valuable during pandemic situations, scoring 4.01 out of 5 in importance [1].
Manage revenue cycles and control costs to maintain financial stability. Economic stability indicators track metrics like average care costs of insured patients, work-staff expenses, and current cost per bed [1].
Line up with industry best practices and meet compliance standards. This approach alleviates risks while improving service quality [2].
Structure and Classification
Healthcare KPIs vary in structure based on what organizations need and value. A detailed study identified 41 indicators across four domains: social stability (10 indicators), economic stability (8 indicators), internal process (9 indicators), and technical domain (14 indicators) [1].
Organizations can group these indicators into clusters based on how they relate. One cluster might combine metrics about patient stay duration, clinical errors, and facility quality. Another might focus on patient satisfaction, costs, and mortality rates [1].
Implementation Through Dashboards
Many organizations use dashboards to monitor information in real time and maximize their KPIs’ value. These tools let you examine details by unit, shift, or provider [2]. Visual displays clearly show what works and what needs fixing, which leads to more responsive care delivery.
Setting specific targets for each KPI and checking progress regularly ensures you meet goals. You can adjust your approach as new results come in [3]. This strategy turns KPIs from simple measurements into powerful tools that drive improvement and strategic decisions.
Careful selection and consistent measurement of KPIs creates a foundation for meaningful comparisons between healthcare institutions over time [3]. This approach leads to better outcomes for both your organization and your patients.
Why Healthcare KPIs Matter for Strategic Success
Healthcare organizations must track their performance to succeed in today’s fast-changing landscape. Hospital leaders can identify strengths, weaknesses, and areas that need improvement through performance tracking [4].
Healthcare KPIs do more than just collect data. These metrics help transform medical practices by measuring and analyzing key operational metrics. This helps teams spot inefficiencies, streamline workflows, and improve patient care [2].
Driving Data-Based Strategic Decisions
Healthcare KPIs build the foundation for evidence-based strategic decisions. Organizations can make smart choices that lead to better patient outcomes and optimal resource use by tracking these metrics [4]. KPI tracking has shown a direct link between strategic measurement and financial success in medical practices [2].
One healthcare facility saw immediate financial results after they started tracking KPIs in their allergy department [2]. This shows how performance indicators turn raw numbers into practical insights that boost revenue and patient outcomes.
Enhancing Operational Excellence
Healthcare organizations prioritize operational efficiency. Regular KPI monitoring helps facilities run smoother, cut costs, and deliver better service [3]. Internal process indicators have proved particularly valuable during crises, with a Cronbach alpha of 0.918. This shows their importance in keeping operations stable under pressure [3].
KPIs help organizations understand if they can reach their goals and measure their progress. Modern healthcare facilities rely on this ongoing monitoring to improve their processes and deliver better results [3].
Ensuring Financial Sustainability
About 50% of healthcare leaders say timely patient collections pose their biggest revenue cycle challenge [5]. Financial KPIs give healthcare organizations a clearer picture of their revenue cycle. This helps them stay financially healthy while delivering quality care.
Hospitals use financial indicators like cost per patient and inventory turnover rate. These metrics help balance cost management with clinical excellence [4]. This approach keeps organizations financially stable while they focus on quality patient care.
Fostering Continuous Improvement Culture
KPI tracking creates a culture of continuous improvement across healthcare organizations. Teams become more accountable and transparent with data. This builds a lasting framework for success that responds to patient needs and market changes [2].
Staff members who track key performance indicators help create data-driven environments [2]. This cultural shift enables healthcare facilities to adapt to resource shortages, provider gaps, lower reimbursements, and other changes in healthcare [4].
Supporting Strategic Alignment
Healthcare leaders use KPIs to evaluate, plan, and control through better information and clearer decision-making [4]. These metrics guide daily operations and create roadmaps for long-term success.
Organizations get the best results when their KPIs match their goals, mission, and policies [4]. This alignment supports overall objectives and creates a clear strategic direction.
Centralizing Information for Better Decision-Making
Healthcare leaders make better evidence-based decisions with a standardized KPI system [4]. One hospital project found 58 KPIs across ten categories: patient access, inpatient use, outpatient use, OR use, ER use, generic use, patient safety, infection control, documentation compliance, and patient satisfaction [4].
Each category of indicators serves a specific purpose. Some measure healthcare effectiveness, while others focus on efficiency, timeliness, safety, and patient-centered care [4]. Leaders can make strategic decisions based on complete data rather than gut feelings or partial information.
Types of Healthcare KPIs You Should Know
Healthcare organizations can better focus on specific performance areas by grouping their KPIs into categories that support their strategic goals. Healthcare facilities typically arrange their metrics into five key categories. Each category plays a unique role in managing overall performance.
Operational KPIs
Day-to-day healthcare operations depend on efficiency and effectiveness metrics. These measurements show how well your facility runs and where service bottlenecks might occur.
Key operational indicators include:
Average Patient Wait Time – The time between check-in and seeing a provider directly affects patient satisfaction [6].
Bed Turnover Rate – The number of patients using each bed over time shows patient flow efficiency. High rates might mean rushed care, while low rates could point to unnecessarily long stays [1].
Staff-to-Patient Ratio – The balance between healthcare staff and current patients helps determine the right staffing levels for safe, quality care [1].
Operating Room Utilization – The percentage of time operating rooms see active use during available hours helps streamline surgical scheduling [1].
Medical Equipment Utilization – Usage time of specialized equipment like MRI machines or CT scanners helps facilities spot underutilized resources [1].
Financial KPIs
Financial metrics give a clear picture of revenue generation, cost management, and long-term sustainability.
Net Profit Margin – Revenue left after expenses serves as a complete indicator of financial health [1].
Average Cost per Treatment – Treatment-specific expenses help providers verify service profitability by comparing costs with reimbursement rates [1].
Claims Denial Rate – The percentage of rejected insurance claims often points to problems with coding, documentation, or eligibility checks [1].
Reimbursement Rate – The comparison between billed charges and actual payments might reveal ineffective billing processes or pricing issues [1].
AR Turnover – A facility’s efficiency in collecting accounts receivable shows up in this ratio, with higher numbers suggesting better billing practices [1].
Clinical and Quality KPIs
Patient outcomes, care quality, and safety metrics directly shape health results.
Patient Satisfaction Index – Survey results reveal how patients feel about their healthcare experience and the quality of care they received [1].
Readmission Rate – The percentage of patients who return within 30 days after discharge might indicate problems with care quality or discharge planning [1].
Complication Rate – Tracking adverse events related to medical treatments helps identify patterns and areas needing improvement [1].
Mortality Rate – This metric shows how well providers can stabilize patients’ conditions after procedures [7].
Healthcare-Acquired Infections – These infections that occur during treatment serve as a key safety indicator [7].
Internal Process KPIs
Healthcare facilities use internal process indicators to optimize operations and boost patient outcomes.
Medication Error Frequency – The number of errors per medication orders highlights potential issues in prescription or administration [1].
Clinical Errors – Recent assessment studies show this metric’s high importance with a loading factor of 0.847, especially during pandemics [8].
Infection Rate – Recent studies give healthcare-associated infections a loading factor of 0.770 [8].
Laboratory Test Time – Performance studies rate test result delivery efficiency with a loading factor of 0.720 [8].
Bed Occupancy Rate – This metric helps optimize capacity planning by tracking occupied bed percentages [8].
Public Health KPIs
Community-wide health initiatives and outcomes extend beyond individual patient care.
Childhood Immunizations – Vaccination coverage numbers show contributions to community health [9].
Educational Programs – These initiatives break down by program type and target audience [9].
Tobacco and Vaping Prevention – Youth e-cigarette use has jumped from 3.8% in 2012 to 19.8% in 2021 among high school students, making prevention programs vital [3].
Chronic Disease Prevention – Community coalitions tackle obesity and related conditions, which affect two-thirds of Indiana adults and one-third of children [3].
Trauma and Injury Prevention – Leading injury causes need attention since they’re the top cause of death for people aged 1-44 years [3].
Healthcare organizations should pick KPIs that match their strategic goals and needs. A balanced mix of metrics ensures complete performance tracking across all vital aspects of healthcare delivery.
How to Choose the Right KPIs for Your Organization
Healthcare managers face a significant challenge – six out of ten acknowledge they need better ways to measure performance metrics for smarter decisions [5]. Poor indicator choices result in excessive measurement, mismatched goals, reduced user support, and decision paralysis [10].
Arrange with strategic goals
Your organization’s strategic objectives should guide effective KPI selection. The best KPIs come from working backwards from desired outcomes to identify measurable drivers [4]. This method gives you metrics that support your unique vision rather than generic “best practice” metrics that might not match your goals.
Review your organization’s mission first and rank objectives based on urgency, effect, and feasibility. Some goals matter more than others, so ranking helps focus on what truly matters [11]. Next, pick metrics that show these goals best – to cite an instance, Net Promoter Score works well when patient satisfaction tops your list.
Your KPIs should flow smoothly through the organization. Enterprise-wide KPIs need to become clear, doable targets for departments, teams, and individuals [4]. Everyone in your healthcare facility will understand how their role helps achieve broader strategic goals.
The core team involvement
The World Health Organization asks providers to focus on measures that match the information needs of people who use indicators to improve [10]. Research shows broader expert panels helped create a more complete view of patient care [10].
Here’s how to make this work:
- Let cross-functional groups help pick KPIs to reflect broader organizational goals [12]
- Get leaders on board by showing how KPIs match objectives [12]
- Give orientation materials to boost participation and understanding [10]
- Show how each KPI connects to bigger goals and individual work [12]
Organizations that asked users about their indicator knowledge early saw more participation [10]. This team approach enriches the selection process and promotes shared responsibility for outcomes [12].
Use measurement data
Measurement has evolved into a structured system in the United States and United Kingdom to compare hospital outcomes for cost control [2]. Healthcare leaders use it to improve quality, patient outcomes, system performance, and professional growth [2].
After defining KPIs, compare performance with similar academic or healthcare programs inside or outside your organization [8]. Healthcare leaders know the value – over 80% use measurement data to fix business problems and turn data into action [13].
Good measurement helps spot unwanted differences and reduce them [2]. The best performers stand out through data analysis and deep research into what drives their success [2].
The process has statistical testing for data quality, which adds scientific validity and helps set better targets [10]. Top medical practices consistently succeed by tracking KPIs and measuring against other organizations to find areas for improvement [13].
Smart KPI selection based on strategic fit, team input, and measurement data will drive real improvement instead of just collecting numbers.
How to Measure KPIs in Healthcare
Good measurement serves as the foundation of any successful healthcare KPI system. Your organization needs to pick the right metrics and create standard measurement processes that generate reliable, useful data. Let’s look at what makes healthcare KPIs work.
Define clear formulas
Your KPIs need clear definitions to make meaningful improvements and ensure everyone collects data the same way [14]. Random formulas will make your measurements subjective and comparisons worthless. Here’s what you need:
- Create uniform definitions for each KPI to guarantee consistent measurement
- Document the exact calculation method in detail
- Identify required data sources and collection methods
- Establish measurement frequency and responsible parties
Good KPIs measure what they should measure, and they give consistent results whatever person does the measuring [14]. Claim Denial Rate has a precise formula: (Number of denied claims in a period ÷ Total number of claims in that period) × 100, with a measure of 8% or less [15].
Average Wait Time uses this formula: Total wait time ÷ Number of patients [16]. When everyone measures the same way, you can compare results across the board.
Your KPI data needs standard definitions to make meaningful comparisons between facilities [14]. This helps your organization track real performance trends instead of differences in how people measure.
Set realistic targets
KPIs without targets lack direction. Setting the right targets needs careful thought—they should push people while staying achievable.
Your targets should be specific and time-bound [17]. You can set them as absolute numbers (“increase of seven”) or percentages (“increase of 4%”) [17]. You can measure against:
- Internal comparisons: “Surpass last year’s results”
- External benchmarks: “Surpass competitor X”
- Industry best practices: “Become as good as X” [17]
Setting unrealistic goals might hurt team morale [18]. KPIs should help you improve performance steadily, so realistic targets matter [17].
Think about seasonal changes and time gaps between leading and lagging indicators [17]. Revenue cycle management needs accurate liquidation rates—some organizations make mistakes by dividing current month’s placements by collections, which paints the wrong picture [15].
Track over time
Regular KPI monitoring shows trends and lets you adjust quickly. This ongoing process helps you see if you can reach your goals and by how much [8].
Healthcare organizations now use dashboards as standard practice. These visual tools help track information in real-time and let you examine details by unit, team, or provider [16]. A good KPI dashboard should be ready for all stakeholders to see critical results quickly [8].
The dashboard helps leaders understand results, adjust goals, strengthen team performance, and spot strategic issues [8]. Analytics Dashboards can show metrics for each program over time, helping providers watch performance and spot trends [19].
Review your KPIs regularly to check progress and fix problems [18]. These reviews should tell you if your metrics still matter or need changes based on new priorities [20]. Most organizations review KPIs monthly or quarterly to catch trends early and stay in line with changing goals or compliance needs [5].
Consistent tracking and visualization turns your healthcare KPIs from simple numbers into tools that drive improvement, helping you deliver better care and use resources wisely.
Setting SMART Goals for KPI Success
The SMART framework is the life-blood of developing effective healthcare KPIs. Healthcare organizations can set clear targets that lead to meaningful performance improvements by turning vague goals into practical metrics. These five criteria—Specific, Measurable, Achievable, Relevant, and Time-bound—help create solid metrics.
Specific and Measurable
Healthcare KPIs need specificity to remove any doubt. Vague goals like “improve patient care” don’t give proper direction. Specific objectives like “reduce patient wait times in the clinic by hiring an additional nurse and implementing an online appointment scheduling system” show a clear path forward [21]. This clarity helps everyone understand the work to be done.
Measurable KPIs must include quantifiable criteria to track progress effectively. You could change “improve patient satisfaction” to “increase patient satisfaction scores from 75% to 90% in the next six months by conducting monthly patient feedback surveys” [21]. Setting specific, measurable goals creates momentum—just like targeting 1,000 new patient signups works better than simply “being more successful” [1].
Achievable and Relevant
Ambition pushes progress forward, but healthcare KPIs must stay realistic given your resources and time limits. Teams lose motivation with unreachable goals like “double the clinic’s patient volume in one month without any marketing budget” [21]. The better approach focuses on challenging yet doable targets such as “increase patient volume by 20% over six months through targeted local advertising” [21].
Each KPI should line up with your organization’s mission and strategic priorities. This might need deep reflection about your true goals—whether supporting charitable causes, building an internationally recognized brand, or creating a relaxed work culture [1]. Your organization gains clear direction when metrics connect directly to these bigger objectives.
Time-bound and Trackable
Goals without deadlines often get pushed aside. Time-bound KPIs create a sense of urgency with clear end dates [1]. “Implement a new electronic health record system and train all staff by the end of the fiscal year” gives both direction and deadline [21].
Trackable KPIs need regular monitoring through well-laid-out dashboards that stakeholders can access. These visual tools show critical results quickly and openly, which can affect outcomes [8]. Teams can spot working interventions and make needed adjustments through consistent tracking. This creates an active cycle of improvement rather than static measurement.
Healthcare organizations can establish metrics that motivate action, unite teams, and drive strategic success by developing SMART KPIs.
Using a Healthcare KPI Dashboard for Real-Time Insights
Healthcare organizations can turn abstract numbers into applicable information through performance data visualization. A healthcare KPI dashboard functions as the central nervous system that consolidates critical metrics into an easy-to-use visual interface, which supports immediate decision making.
Benefits of centralized dashboards
Healthcare teams face challenges with scattered information stored in multiple formats across different systems [16]. Clear visualizations reduce cognitive burden and create shared clinical processes by simplifying complex data sets [22]. Dashboard implementation has become standard practice, enabling teams to monitor information immediately and examine details by unit, staff changes, or provider [6].
Healthcare dashboards provide several concrete benefits:
- Quick verification of patient insurance coverage protects organizations from revenue loss [6]
- Healthcare teams can spot potentially catastrophic medical issues early [7]
- Multiple data points appear simultaneously on screen to improve accessibility and accountability [22]
- Teams can see which healthcare strategies deliver adequate results [7]
Choosing the right dashboard tool
The best healthcare KPI dashboard needs resilient infrastructure for data integration across clinical and operational systems [23]. The system must highlight trends through simple visualizations that make complex information quick to understand [24].
Dashboard solutions should include these key features:
- Data refreshes almost instantly to help clinical analysis [19]
- Existing ERP systems feed data automatically to minimize manual work [16]
- Different departments can customize interfaces based on their needs [25]
- Users can break down anomalies through detailed analysis [26]
Examples of effective visualizations
Healthcare dashboards excel with visualizations matched to specific operational needs. Call volume dashboards show date and time of every call while tracking outcomes like successful calls, voicemails, or attempted calls [19]. Financial dashboards display claims processing, rejections, and insurance eligibility [6].
User performance reviews showcase metrics like total patients assigned, new patients enrolled, and average case length in days [19]. Simple tab charts combine financial and administrative data with departmental records to reveal key insights about condition commonality, treatment costs, and average length of stay [22].
Common Mistakes to Avoid When Setting Healthcare KPIs
Healthcare organizations waste resources and miss opportunities to improve because their KPIs fail despite careful selection. Understanding these common pitfalls helps organizations succeed.
Tracking too many metrics
Data overload paralyzes decision-making in healthcare organizations [27]. Organizations track excessive metrics with good intentions, but this creates confusion about priorities. The focus on what truly matters gets diluted. To name just one example, some facilities track over 30 KPIs that cause managers to lose sight of critical areas like customer satisfaction and inventory turnover [28].
The organization should:
- Focus on a limited number of metrics to simplify the KPI framework
- Review each KPI’s connection to strategic goals
- Make metrics clear and understandable at every level
Focusing only on lagging indicators
Healthcare has relied heavily on lagging indicators that show past performance [29]. These retrospective metrics cannot help monitor or correct current situations [30]. CAHPS results take 45-60 days after patient encounters to receive [29].
Organizations need to balance lagging indicators with leading metrics. This predicts future performance and allows up-to-the-minute course correction before problems grow.
Ignoring staff input
KPIs face resistance without employee involvement [28]. Staff members need support “to put time aside” to collect data while managing their existing workload [31]. Successful KPI programs need “getting everyone on board,” including staff and patients alike [31].
Conclusion
Healthcare KPIs are essential tools that help navigate today’s complex healthcare world. This piece shows how these metrics turn raw data into practical insights. They drive success in operations, finances, clinical work, internal processes, and public health.
Your healthcare KPIs will work best when you choose metrics that line up with your goals instead of using generic “best practices.” The core team from your organization should be part of this process to ensure better acceptance and complete points of view.
Well-designed KPIs become powerful when they follow the SMART framework. This approach turns unclear goals into real targets that teams can achieve. KPIs need to be specific, measurable, achievable, relevant, and time-bound.
Your KPI system must balance complete measurement with focused action. Too many metrics can lead to decision paralysis. Looking only at past indicators won’t let you make timely adjustments. A good dashboard fixes these issues by showing real-time data in clear visuals that help quick decisions.
Start small with a few vital KPIs that support your urgent strategic goals. Once you have consistent measurement processes in place, you can add more metrics while keeping clear links to organizational objectives.
Organizations that use KPIs well go beyond just measuring things. They build a culture of continuous improvement. These teams use information to spot opportunities, make targeted changes, and check results. This creates an ongoing cycle of excellence that helps patients, staff, and profits.
Note that collecting data isn’t the main goal of healthcare KPIs – improving patient outcomes while optimizing resources is. When your measurement system supports this basic goal, KPIs become powerful tools for meaningful change rather than administrative tasks.
References
[1] – https://www.grow.com/blog/how-to-use-smart-goals-to-build-your-kpis
[2] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8812166/
[3] – https://www.in.gov/healthfirstindiana/key-performance-indicators/
[4] – https://cbsteam.com/metrics-that-matter-ensuring-your-kpis-truly-align-with-and-support-your-strategic-objectives/
[5] – https://www.meditab.com/blog/top-healthcare-kpis-every-healthcare-practice-should-track-for-long-term-success
[6] – https://www.netsuite.com/portal/resource/articles/erp/healthcare-dashboards.shtml
[7] – https://www.inetsoft.com/business/bi/healthcare-kpi-data-visualizations/
[8] – https://pmc.ncbi.nlm.nih.gov/articles/PMC10982069/
[9] – https://www.clearpointstrategy.com/blog/25-healthcare-metrics-kpis
[10] – https://pmc.ncbi.nlm.nih.gov/articles/PMC9038160/
[11] – https://www.intrafocus.com/2023/10/aligning-kpis-with-organizational-goals/
[12] – https://www.omnihr.co/blog/how-to-set-kpi
[13] – https://www.mgma.com/articles/foundational-benchmarks-and-kpis-for-medical-practice-operations-in-2023
[14] – https://www.hiqa.ie/sites/default/files/2017-01/KPI-Guidance-Version1.1-2013.pdf
[15] – https://revcosolutions.com/revenue-cycle-kpi-glossary-definitions-formulas-and-benchmarks/
[16] – https://insightsoftware.com/blog/25-best-healthcare-kpis-and-metric-examples/
[17] – https://bernardmarr.com/how-to-set-the-right-targets-for-kpis-top-target-setting-tips-for-successful-metrics/
[18] – https://www.rivethealth.com/blog/key-performance-indicators-in-healthcare
[19] – https://www.thoroughcare.net/blog/tracking-care-management-key-performance-indicators
[20] – https://www.netsuite.com/portal/resource/articles/erp/healthcare-kpis.shtml
[21] – https://www.wrshealth.com/blog/medical-practice-smart-goals-tep
[22] – https://www.usfhealthonline.com/resources/healthcare-analytics/how-data-visualizations-and-dashboards-can-improve-healthcare-outcomes/
[23] – https://www.gooddata.com/blog/healthcare-dashboards-examples-use-cases-and-benefits/
[24] – https://www.leadsquared.com/industries/healthcare/healthcare-dashboard/
[25] – https://www.simplekpi.com/Blog/KPI-Dashboards-a-comprehensive-guide
[26] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8928055/
[27] – https://hbr.org/2022/03/fixing-data-overload-in-health-care
[28] – https://mark-bridges.medium.com/what-are-the-common-mistakes-and-pitfalls-made-in-kpi-implementation-8edfd25bd35b
[29] – https://www.medallia.com/blog/leading-indicators-in-healthcare/
[30] – https://pmc.ncbi.nlm.nih.gov/articles/PMC4685598/
[31] – https://pmc.ncbi.nlm.nih.gov/articles/PMC9545178/
