Pay for performance: learning about quality

Bell, Chaim M.; Levinson, Wendy

doi:10.1503/cmaj.070472

Cited by 18 publications

(16 citation statements)

References 10 publications

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“…32 However, it can also distract efforts from non-targeted outcomes. 33 When competing demands are modest, a small incentive is probably all that is needed to reweight priorities. But when competing demands are heavy, small incentives may not be able to change the decision equation.…”

Section: System Inertia and Health Reformmentioning

confidence: 99%

Why system inertia makes health reform so difficult

Coiera

2011

BMJ

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Section: System Inertia and Health Reformmentioning

confidence: 99%

Why system inertia makes health reform so difficult

Coiera

2011

BMJ

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“…The characteristics of the EQA are aligned with those described as essential for good indicators (Houghton and Rouse 2004; Bell and Levinson 2007): it is simple to calculate (the subindicators are proportions); easy to interpret, both for healthcare professionals who periodically look at their results and for various levels of management; relevant in the sense that the subindicators are based on health problems that stand out in primary care; and can be validated by feedback from healthcare professionals.…”

Section: Discussionmentioning

confidence: 94%

Creation of a synthetic indicator of quality of care as a clinical management standard in primary care

et al. 2013

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IntroductionThe development of electronic medical records has allowed the creation of new quality indicators in healthcare. Among them, synthetic indicators facilitate global interpretation of results and comparisons between professionals.MethodsA healthcare quality standard (EQA, the Catalan acronym for Estàndard de Qualitat Assistencial) was constructed to serve as a synthetic indicator to measure the quality of care provided by primary care professionals in Catalonia (Spain). The project phases were to establish the reference population; select health problems to be included; define, select and deliberate about subindicators; and construct and publish the EQA.ResultsConstruction of the EQA involved 107 healthcare professionals, and 91 health problems were included. In addition, 133 experts were consulted, who proposed a total of 339 indicators. After systematic paired comparison, 61 indicators were selected to create the synthetic indicator. The EQA is now calculated on a monthly basis for more than 8000 healthcare professionals using an automated process that extracts data from electronic medical records; results are published on a follow-up website. Along with the use of the online EQA results tool, there has been an ongoing improvement in most of the quality of care indicators.ConclusionsCreation of the EQA has proven to be useful for the measurement of the quality of care of primary care services. Also an improvement trend over 5 years is shown across most of the measured indicators.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-2-51) contains supplementary material, which is available to authorized users.

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“…Those in developed countries aim to improve the quality of care, reducing less desirable services in favor of more desirable ones, and lowering costs (Bell and Levinson 2007;Greene and Nash 2009). In Sub-Saharan Africa, the main issues are still related to insufficient access and low use of services, particularly for highimpact interventions and for the poor.…”

Section: Productionmentioning

confidence: 99%