European Journal of Operational Research ( IF 6.4 ) Pub Date : 2021-07-25 , DOI: 10.1016/j.ejor.2021.07.037 Olena Kalinichenko 1 , Carla A.F. Amado 1 , Sérgio P. Santos 1
In recent years, implementation of pay-for-performance (P4P) programmes in health care has become a worldwide initiative. However, most P4P programmes incorporate systems of Performance Indicators (PI) without accounting for trade-offs between indicators. This article has two objectives: (1) to develop a Data Envelopment Analysis (DEA) methodology for performance assessment of primary care providers; and (2) to propose an innovative methodology for P4P contracting based on the DEA assessment results. To achieve the first objective, we modify the standard DEA model to account for the necessary relations between the weights attributed to each PI and domain of performance and to account for the effect of the relevant environmental variables. To achieve the second objective, we combine relative and absolute performance assessments in the elaboration of several bases for reward, and then we link these assessments to a system of graduated rewards. A benchmarking programme is also proposed to contribute to the dissemination of best practices. This article contributes to the literature by proposing an enhanced methodology for performance assessment of primary care providers which can form the basis for P4P rewards planning. The applicability and advantages of the proposed methodology are illustrated with data from Portugal, but it can easily be adapted to different sets of PIs or domains, making it relevant for performance assessment and for P4P reward setting in other contexts and countries.
中文翻译:
探索数据包络分析在增强初级卫生保健绩效薪酬计划设计方面的潜力
近年来,在医疗保健领域实施按绩效付费 (P4P) 计划已成为一项全球倡议。然而,大多数 P4P 程序都包含性能指标 (PI) 系统,而没有考虑指标之间的权衡。本文有两个目标:(1) 开发一种用于初级保健提供者绩效评估的数据包络分析 (DEA) 方法;(2) 基于 DEA 评估结果提出 P4P 承包的创新方法。为了实现第一个目标,我们修改了标准 DEA 模型,以说明归因于每个 PI 的权重与性能领域之间的必要关系,并说明相关环境变量的影响。为了实现第二个目标,我们将相对和绝对绩效评估结合起来制定奖励的几个基础,然后我们将这些评估与分级奖励系统联系起来。还提出了一项基准计划,以促进最佳做法的传播。本文通过提出一种增强的初级保健提供者绩效评估方法来为文献做出贡献,该方法可以构成 P4P 奖励计划的基础。葡萄牙的数据说明了所提议方法的适用性和优势,但它可以很容易地适应不同的 PI 或领域,使其与其他环境和国家的绩效评估和 P4P 奖励设置相关。还提出了一项基准计划,以促进最佳做法的传播。本文通过提出一种增强的初级保健提供者绩效评估方法来为文献做出贡献,该方法可以构成 P4P 奖励计划的基础。葡萄牙的数据说明了所提议方法的适用性和优势,但它可以很容易地适应不同的 PI 或领域,使其与其他环境和国家的绩效评估和 P4P 奖励设置相关。还提出了一项基准计划,以促进最佳做法的传播。本文通过提出一种增强的初级保健提供者绩效评估方法来为文献做出贡献,该方法可以构成 P4P 奖励计划的基础。葡萄牙的数据说明了所提议方法的适用性和优势,但它可以很容易地适应不同的 PI 或领域,使其与其他环境和国家的绩效评估和 P4P 奖励设置相关。