Should we have confidence if a physician is accredited? A study of the relative impacts of accreditation and insurance payments on quality of care in the Philippines

Abstract

It is unclear whether health provider accreditation ensures or promotes quality of care. Using baseline data from the Quality Improvement Demonstration Study (QIDS) in the Philippines we measured the quality of pediatric care provided by private and public doctors working at the district hospital level in the country's central region. We found that national level accreditation by a national insurance programme influences quality of care. However, our data also show that insurance payments have a similar, strong impact on quality of care. These results suggest that accreditation alone may not be sufficient to promote high quality of care. Further improvements may be achieved with properly monitored and well-designed payment or incentive schemes.

The population-level impacts of a national health insurance program and franchise midwife clinics on achievement of prenatal and delivery care standards in the Philippines

“…In addition, they may be more likely to seek prenatal care due to implementation of accreditation standards, which may be associated with improvements in service provision and quality of care [25]. A recent study corroborates this idea, indicating that both national-level accreditation and insurance payments influence the quality of health care provision in the Philippines [49]. Hospital accreditation may improve the condition of facilities and the quality of care offered.…”

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis

“…Incentives for accreditation could include legal requirements, for marketing and publicity, becoming consistent with government policy, and for voluntary organisational development. 51 The incentives for participation in accreditation may vary among public and private hospitals. For public hospitals, accreditation may help to provide evaluation data for performance assessment, which could inform policyplanning decisions and improve facilities.…”

“…Consistency of policy support, programme funding, and incentives for participation could be the challenges to sustain the programme. 51 Lack of incentives for participation and high costs for sustaining such programmes were identified as threats to accreditation. It is critical to plan ahead with respect to infrastructure, research, and development costs in different stages of implementation, as well as to secure funding.…”

Active pharmaceutical management strategies of health insurance systems to improve cost-effective use of medicines in low- and middle-income countries: A systematic review of current evidence

“…A study of the Philippines NHI found that connecting accreditation and insurance payments to compliance with clinical guidelines had a positive effect on overall quality of care [79]. Similarly, a study of a pay-for-performance program in the Taiwan NHI found that the program improved outpatient services and reduced inpatient services and costs [80].…”