Impact of payment methods on professional equity of physicians

Peña-Sánchez, Juan Nicolás; Lepnurm, Rein; Dobson, Roy; Keegan, David L.

doi:10.5430/jha.v3n2p50

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Diğer ödeme modellerinde ise hekimin sağlık hizmeti üretimini karşılığı alacağı ücreti sabit (maaş) veya hacim ve frekansa bağlı olarak ödenmektedir. Performansa dayalı ödeme sistemi, hem kaliteli sağlık bakım hizmetleri üretimini (Werner et al, 2011) hem de hasta memnuniyetinin artırılmasını (Kwon, 2003:84-85) ek ödeme, ikramiye ve ödül gibi araçlarla teşvik etmektedir (Pham, Schrag, andO'Malley, 2007:1131;Peña-Sánchez, et al, 2013).…”

Section: Tartişma Ve Sonuçunclassified

Performansa Dayali Ek Ödeme Si̇stemi̇nde Heki̇mleri̇n Tekni̇k Veri̇mli̇li̇ği̇: Bi̇r Üni̇versi̇te Hastanesi̇nde Uygulama

Yiğit

2017

Elektronik Sosyal Bilimler Dergisi

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Bu araştırmanın amacı bir üniversite hastanesinde görev yapan hekimlerin performansa dayalı ek ödeme sisteminde teknik verimliliklerini analiz etmektir. Araştırmada Veri Zarflama Analizi (VZA) yöntemi kullanılmıştır. VZA analizinde CCR ve BCC modeline göre hekimlerin performans düzeyleri analiz edilmiştir. Performans ölçüm modeli beş çıktıdan (poliklinik sayısı, yatan hasta sayısı, yatak doluluk oranı, sağlık hizmeti geliri) ve bir girdiden (performansa dayalı ek ödeme tutarı) oluşmaktadır. Araştırmada girdi ve çıktı değişkenlerinin analizi VZA programı ile gerçekleştirilmiştir. VZA sonucu, araştırma kapsamındaki hekimlerin ek ödemeye dayalı uygulamada teknik verimlilik düzeyi BBC modeline göre ortalama %67, CCR modeline göre %57 olduğu saptanmıştır. Ayrıca performansa dayalı ek ödeme kapsamında her bir hekimin teknik verimlilik tespit edilmiş ve potansiyel iyileştirme önerilerinde bulunulmuştur. Hastaneler maliyet etkin ve kaliteli bir sağlık hizmeti üretebilmeleri için hekimlerin motivasyonunun artırması gerekmektedir.

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Section: Tartişma Ve Sonuçunclassified

Performansa Dayali Ek Ödeme Si̇stemi̇nde Heki̇mleri̇n Tekni̇k Veri̇mli̇li̇ği̇: Bi̇r Üni̇versi̇te Hastanesi̇nde Uygulama

Yiğit

2017

Elektronik Sosyal Bilimler Dergisi

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Prioritizing the Challenges of Compensation Methods for Doctors and Nurses in Iranian Public Hospitals

Maleki,

Javaheri Zadeh,

Ferdowsi

2024

Depiction of Health

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Background. Designing a payment system for healthcare workers- doctors and nurses, in particular- in the hospitals is more intricate than that for other organizations. Beyond the legal compliance, the unique features of the medical professions and nursing work environment should be considered. Due to the lack of adequate researches on payment methods for doctors and nurses in Iran, especially regarding the recent changes in "fee for services" (FFS) payment, the present study aimed to investigate the payment challenges faced by the doctors and nurses in Iranian public hospitals. Methods. Challenges were identified by interviews, and prioritized by adopting the MARCOS method. The study population included the hospital managers, healthcare payment method experts, and doctors and nurses in the public hospitals. Targeted sampling and semi-structured interviews were conducted to collect the data. In the MARCOS method, criteria determination, weighting, and scoring of the challenges were performed by five experts in the field of healthcare payment. Criteria included decreased motivation (25%), reduced productivity (15%), correction cost (40%), and implementation difficulty of the correction (20%). Calculations were performed using Excel software and determining the relevant priorities. Results. A total of 16 interviews were conducted in this study, with 10 interviews about the academic faculty and hospital managers in Isfahan University of Medical Sciences, three about the nursing experts in Tehran, and three about the Ministry of Health experts. According to MARCOS method calculations, the top 4 challenges in compensating doctors were identified as: low FFS ceiling, lack of job difficulty incentives, the inadequate impact of full-time work, and the progressive taxing. Additionally, the 2 primary challenges in compensating nurses were: irregular payment of FFS, and collective payment of FFS instead of individual payment. Conclusion. At the time of this study, Iranian public hospitals provided the doctors with individual rights, benefits, and allowances, while it provided the nurses with collective rights, benefits, and overtime pay. Although these compensation methods often posed different challenges, most of the issues were associated with the allowance payments. By prioritizing key challenges, authorities may have developed the necessary solutions for addressing the challenges as well as enhancing the satisfaction of doctors and nurses in Iranian public hospitals.

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Impact of payment methods on professional equity of physicians

Cited by 2 publications

References 26 publications

Performansa Dayali Ek Ödeme Si̇stemi̇nde Heki̇mleri̇n Tekni̇k Veri̇mli̇li̇ği̇: Bi̇r Üni̇versi̇te Hastanesi̇nde Uygulama

Performansa Dayali Ek Ödeme Si̇stemi̇nde Heki̇mleri̇n Tekni̇k Veri̇mli̇li̇ği̇: Bi̇r Üni̇versi̇te Hastanesi̇nde Uygulama

Prioritizing the Challenges of Compensation Methods for Doctors and Nurses in Iranian Public Hospitals

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