Pay-for-performance and tools for quality assurance in health care

Donev, Doncho

doi:10.11576/seejph-5115

Cited by 2 publications

(31 citation statements)

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“…This study focuses on technical issues and implementation challenges. Another study 33 looked at the experiences and factors of performance-based payment in Southeastern European countries, while the last study 34 provided a comprehensive overview of DRG-based hospital payment systems in low- and middle-income countries. It examines design and implementation issues as well as related challenges in these countries.…”

Section: Resultsmentioning

confidence: 99%

“… [ 41 , 43 , 48 , 49 , 55 , 57 , 61 , 65 , 70 , 79 ] Provider reluctance or opposition to reform initiatives seeming to compromise their professional/ clinical autonomy or ethics. [ 31 , 33 , 37 , 39 , 52 , 53 , 55 , 57 , 69 , 80 ] Distrust due to previously failed reform attempts or between stakeholders (eg, care providers and government). [ 33 , 41 , 43 , 47 , 48 , 62 ] Reluctance due to difficulty/the inertia of providers to adjust to the new structure in healthcare.…”

Section: Resultsmentioning

confidence: 99%

“… [ 31 , 33 , 37 , 39 , 52 , 53 , 55 , 57 , 69 , 80 ] Distrust due to previously failed reform attempts or between stakeholders (eg, care providers and government). [ 33 , 41 , 43 , 47 , 48 , 62 ] Reluctance due to difficulty/the inertia of providers to adjust to the new structure in healthcare. [ 14 , 47 , 52 , 61 , 74 ] Providers reluctance to adopt new payment models because they feel better familiar with the current one.…”

Section: Resultsmentioning

confidence: 99%

“… [ 14 , 31 , 41 , 61 , 65 ] Provider opposition to reform initiatives developed without evidence-based facts (clinical, cost, quality, etc.). [ 33 , 43 , 49 , 77 ] Provider reluctance due to finding a method as confusing eg, because of the varieties of benchmarks being used for performance programs. [ 40 , 46 , 52 , 69 ] Provider opposition to reform initiatives intending to expose client’s privacy / seen as causing negative patient physician relationship.…”

Section: Resultsmentioning

confidence: 99%

“… [ 40 , 46 , 52 , 69 ] Provider opposition to reform initiatives intending to expose client’s privacy / seen as causing negative patient physician relationship. [ 14 , 33 , 37 ] Provider opposition to reform initiatives they are not involved in arrangement. [ 33 ] Challenges related to the reform design features Unavailability of standards/benchmarks (quality, cost, risk-adjustment, etc.).…”

Section: Resultsmentioning

confidence: 99%

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Barriers and Facilitators to Health-Care Provider Payment Reform – A Scoping Literature Review

Ndayishimiye,

Tambor,

Dubas-Jakóbczyk

2023

RMHP

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Background Changes to provider payment systems are among the most common reforms in health care. They are important levers for policymakers to influence the health system performance. The aim of this study was to identify, systematize, and map the existing literature on the factors that influence health-care provider payment reforms. Methods A scoping review was conducted. Literature published in English between 2000 and 2022 was systematically searched in five databases, relevant organizations, and journals. Academic publications and grey literature on health-care provider payment reform and the factors influencing reform were considered. An inductive thematic analysis was applied to map the barriers and facilitators that influence payment reforms. Results The study included 51 publications. They were divided into four categories: empirical studies (n=17), literature reviews (n=6), discussion/policy papers (n=18), and technical reports/policy briefs (n=9). Most of the studies were conducted in developed economy countries (n=36). The most frequently reformed payment method was fee-for-service (n=37), and the newly implemented methods included bundled payments (n=16), pay-for-performance (n=15), and diagnosis-related groups (n=11). This study identified 43 sub-themes on barriers to provider payment reforms, which were grouped into eight main themes. It identified 51 sub-themes on facilitators, which were grouped into six themes. Barriers include stakeholder opposition, challenges related to reform design, hurdles in implementation structures, insufficient resources, challenges related to market structures, legal barriers, knowledge and information gaps, and negative publicity. Facilitators include stakeholder involvement, complementary reforms/policies, relevant prior experience, good leadership and management of change, sufficient resources, and external pressure to introduce reform. Conclusion The factors that influence health-care payment reforms are often contextual and interrelated, and encompass a variety of perspectives, including those of patients, providers, insurers, and policymakers. When planning reforms, one should anticipate potential barriers and devise appropriate interventions. Registration The study was registered with the Open Science Framework.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Barriers and Facilitators to Health-Care Provider Payment Reform – A Scoping Literature Review

Ndayishimiye,

Tambor,

Dubas-Jakóbczyk

2023

RMHP

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Overview of the main incremental health care reforms introduced between 2014 and 2020 in Romania

Scîntee¹,

Vlădescu²

2023

SEEJPH

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Aim: On 2014 the Government of Romania has committed to improving health and health system through the implementation of the 2014–2020 National Health Strategy: Health for Prosperity. An official evaluation of the strategy implementation is not publicly available yet. This paper aims to provide an overview of the main incremental reforms taken during this period in Romania and to analyse the results from the perspective of the main Strategy goals. Methods: Information was collected from legislative documents, statistical and scientific publications. The main implemented or initiated incremental reforms, during the assessed period, were assigned to five main clusters: ”governance”, “resources for health”, “coverage and access”, “organization of health care”, “quality of care” and were analysed in accordance with the aim, the type, the implementation stage and the corresponding objectives of the Strategy. Results: The 2014–2020 National Health Strategy has definitely not reached all its objectives, but one sign of prosperity, is that based on 2019 per capita income (of $12,630) World Bank classified Romania, for the first time, as a high-income country. The health status of the population has increased in many aspects, yet Romanians’ health has still remained among the poorest in the European Union (EU). Conclusion: Incremental reforms might be successful, but the small steps should be taken in a holistic approach, and should be tailored to specific needs. Previous strengthening health systems resilience and plans for overcoming possible risks and obstacles might ensure successful implementation. Assessments of the reforms might draw lessons that help policymakers in shaping further health policies and designing of next strategies.

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Pay-for-performance and tools for quality assurance in health care

Cited by 2 publications

References 0 publications

Barriers and Facilitators to Health-Care Provider Payment Reform – A Scoping Literature Review

Barriers and Facilitators to Health-Care Provider Payment Reform – A Scoping Literature Review

Overview of the main incremental health care reforms introduced between 2014 and 2020 in Romania

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