Physician Knowledge and Attitudes Toward Pay-for-performance Programs: An Example of Medical Benefit Improvement Project in Diabetes Mellitus
Date Issued
2009
Date
2009
Author(s)
Chen, Meng-Yu
Abstract
Background and Objectives: In 2001, the pay-for-performance programs was applied in 5 main diseases in Taiwan. Among them, the program for diabetes mellitus firstly adopted clinical outcome indicators as the reward basic. That was the real first step in rewarding the “performance.” Studies from foreign countries have investigated physicians’ knowledge and attitudes toward the pay-for-performance system in order to understand the implementation conditions and evaluate its effectiveness. However, local studies related to this issue are limited. This study aimed at understanding the knowledge and attitudes toward the pay-for-performance among physicians who participated in the diabetes mellitus pay-for-performance program. In addition, the relationships among physician’s attitudes, knowledge, personal characteristics, and characteristics of healthcare institutions were examined.ethods: The investigation instrument in this study was based on the “Provider Attitudes toward Incentives” questionnaire developed by Meterko and his colleagues. Additional questions were added to fit the research purposes. According to the validity test by three experts and a pilot test for 8 physicians, several questions were revised. This was a cross-sectional study focusing on physicians participated in the diabetes mellitus pay-for-performance program in Taiwan. A purposive sampling method was adopted. 585 questionnaires were distributed between April 24th and June 3rd, 2009 and 207 valid questionnaires were returned. The valid response rate was 35.38%.esults: Study results showed that most of the physicians held a positive attitude toward the pay-for-performance mechanism. 83.6% of the physicians thought that the Bureau of National Health Insurance should provide financial incentives to a physician when his/ her services achieved a better quality. 75.4% of the physicians believed that the financial incentive was an effective approach to improving quality of health care. 71% of the physicians suggested that financial incentives were better than non-financial incentives. Most of the physicians applauded the “anticipated outcome” under the diabetes mellitus pay-for-performance program, while they approved with the “organizational support” less. This situation was especially significant with respect to the “financial support”, that 40.6% of the physicians did not think the amount of eimbursement under the “Medical Benefit Improvement Project in Diabetes Mellitus” could compensate the effort they spent to fulfill the goal. This study also found that physician’s education level, characteristics of the healthcare institution, and physician’s knowledge of the program could impact the physician’s attitudes toward the program. Through the self-administered questionnaires, those who understood the program and the financial distribution more were more likely to have a positive attitude toward the pay-for-performance program. Furthermore, the encouragement from the chief of an institution could contribute to physician’s positive attitudes toward the program.uggestions: Suggestions for future study include: using the qualitative method to strengthen the healthcare institution aspect to understand its impact on the implementation of the pay-for-performance program and the distribution of financial incentives within an institution; exploring the relationship between attitudes and behavior; broaden the investigation targets to include nurses, nutrition consultants, health education practitioners, and even patients; studying the effect of this program in other diseases.
Subjects
Pay-for-performance
Medical Benefit Improvement Project in Diabetes Mellitus
Physician’s attitude
Physician’s knowledge
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-98-R96843014-1.pdf
Size
23.32 KB
Format
Adobe PDF
Checksum
(MD5):82a21848991337a9db75dbbf0ac29724