Document Type : Original Article
Authors
1 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
2 Health Information Technology Research Center, Student Research Committee, Department of Medical Library and Information Sciences, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: One of the main goals of hospital management is to attract, maintain, and increase
the number of qualified and efficient human resources, and one of the key and most important factors
in achieving this goal is to design and implement a fair and efficient payment system. The purpose
of this project is to determine the challenges of the performance‑based payment system and provide
solutions to overcome its obstacles in the city of Tehran.
MATERIALS AND METHODS: This qualitative research sought to perform content analysis so as
to explore the experiences and perceptions of a purposeful group of specialists and managers of
Tehran’s educational and medical centers (n = 10). Data were collected using in‑depth semi‑structured
interviews and were ongoing until the point of saturation.
RESULTS: On analysis of data by Specialists and managers of Tehran’s educational and medical
centers, three main themes including behavior, organization, rules and regulation were defined
alongside seven subthemes includes scheduling, platform, education, quantity‑oriented, motivation,
implementation, and payment system.
CONCLUSION: In general, it can be concluded that for the successful implementation of any project,
the necessary infrastructure must be provided for implementation. In this plan, despite the challenges
in the field of behavior, organization, and rules and regulations, the need for necessary training
before implementing the plan, special attention to quality instead of quantity, motivating employees
to cooperate in implementing the plan as successfully as possible, creating a platform Appropriate
before the implementation of the plan and most importantly, the pilot implementation of the plan
before its widespread implementation seems necessary.
Keywords
reflections on the discourse, evidence and unanswered questions.
Health Policy Plann 2009;24:160‑6.
2. Turenne M, Baker R, Pearson J, Cogan C, Mukhopadhyay P,
Cope E. Payment reform and health disparities: Changes in
dialysis modality under the new medicare dialysis payment
system. Health Services Res 2018;53:1430‑57.
3. Jabbari A, Shaarbafchi Zadeh N, Maddahian B. Identifying
executive challenges of performance‑based payment from
medical and educational hospitals administrators’ perspective
and offering solutions in Isfahan (2018). Evid Based Health Policy
Manage Econ 2019;3:121‑30.
4. Ghaedi H, Dost ER, Ghanei M, Razeghi A, Kalani N, Akbari H.
A cross‑sectional descriptive study on performance‑based
payment and the respective satisfaction on diagnosis, therapeutic
and support‑staffs of Jahrom hospitals. Ambient Sci 2018;5:84‑9.
5. Aghajani M, Olyaeemanesh A, Manavi S, Ronasian R,
Yusefvand M, Poraghasi L, et al. Evaluating the effectiveness
and process of implementation of the new payment‑based
performance model in compared to the new system of hospitals
administration in the health transformation plan. Hakim Res J
2018;20:213‑25.
6. Slotkin JR, Ross OA, Newman ED, Comrey JL, Watson V, Lee RV,
et al. Episode‑based payment and direct employer purchasing of
healthcare services: Recent bundled payment innovations and the
Geisinger Health System experience. Neurosurgery 2017;80:S50‑8.
7. Li L, Fu H. China’s health care system reform: Progress and
prospects. Int J Health Plann Manage 2017;32:240‑53.
8. Haeussler B, Zich K, Bless HH. Does the implementation of a
new payment system for hospital services induce changes in the
quality of health care? Experiences from Germany. BMC Health
Serv Res 2014;14 Suppl 2:O18.
9. Shon C, You M. Evaluation of health policy governance in the
introduction of the new DRG‑based hospital payment system
from interviews with policy elites in South Korea. Int J Environ
Res Public Health 2020;17:3757.
10. Kondo KK, Damberg CL, Mendelson A, Motu’apuaka M,
Freeman M, O’Neil M, et al. Implementation processes and pay
for performance in healthcare: A systematic review. J Gen Internal
Med 2016;31:61‑9.
11. Greengarten M, Hundert M. Individual pay‑for‑performance
in Canadian healthcare organizations. Healthcare Papers
2006;6:57‑61.
12. Ryan AM, Burgess JF Jr., Pesko MF, Borden WB, Dimick JB. The early effects of Medicare’s mandatory hospital pay-forperformance program. Health Services Res 2015;50:81‑97.
13. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S,
Greenberg N, et al. The psychological impact of quarantine
and how to reduce it: Rapid review of the evidence. Lancet
2020;15 (4),11‑18.
14. Cashin C, Chi Y‑L, Smith PC, Borowitz M, Thomson S. Paying
for performance in health care: implications for health system
performance and accountability: McGraw‑Hill Education (UK);
2014.
)