Developing regional tailored health care targets on a federal level - a multi stage delphi process.

Abstract: The development of regionally tailored healthcare goals and targets shared by all stakeholders is essential for a high-quality healthcare system. This study outlines the development of a generic framework for creating patient-centered, cross-sectoral healthcare targets, applying a multi-stage, hybrid Delphi process and using Saxony, Germany as an example. The process involved key stakeholders, including policymakers, healthcare providers, and patient representatives, and focused on two use cases: child and adolescent health and dementia. Through expert interviews, online surveys, and workshops, five thematic domains were identified: digitalization, patient orientation, cross-sectoral care, securing skilled workers, and health(-system) competence. A total of 15 healthcare targets were developed, addressing structural and process improvements at macro, meso, and micro levels. While digitalization targets were rated highest in alignment with SMART criteria, patient orientation targets showed room for improvement. The study highlights the importance of stakeholder consensus, measurable indicators, and iterative adjustments to ensure effective implementation. Despite challenges such as limited measurability and tight timelines, the results provide a transferable framework for developing healthcare targets that can guide strategic planning and resource allocation. This approach contributes to optimizing healthcare delivery and achieving equitable, needs-based care in Saxony and beyond.