Journal of Qualitative Research in Health Sciences

Authors

medical university isfahan

Abstract

Introduction: In year 1995, new hospital administration plan system (fee for service) was notified. Under the scheme, a dedicated percentage of specific revenues allocated as a fee for the hospital staff. In the early September 2014, new guidelines as performance-based fee for service plan with the aim to fix the deficiencies in the previous plan was reviewed and implemented in hospitals in Isfahan, Iran. This study aimed to investigate strategies for economic reforms to promote performance monitoring and improve infrastructure for implementation of the new fee for service guidelines in 2014.
Method: In this qualitative study, in-depth interviews were used to collect the data. Eleven samples consisting of middle managers and senior headquarters of university hospitals, and some faculty members and hospital officials were chosen via purposive sampling method. All interviews were recorded and then written on paper. The duration of interviews varied between 30 to 60 minutes. Data analysis in this research was based on content analysis.
Results: In this study, six main themes of strategies for economic reforms to promote performance monitoring and improve infrastructure for implementation of the new fee for service guidelines were obtained including payment system reform, price reform, defined package of services in public hospitals, financial and economic policies, reform and implementation of family physician referral system, and support of the insurers.
Conclusion: Our results define strategies for economic reforms to promote performance monitoring and improve infrastructure for implementation of the new fee for service guidelines. The most notable findings include pay reform, price reform, and financial and economic policies. These findings can help policy makers to consider the proposed revisions with appropriate strategies to monitor and improve the implementation of new fee for service plan.

Keywords

1. Roberts M, Hsiao W, Berman P, Reich M. Getting health reform right: a guide to improving performance and equity: Oxford university press; 2008. 2. Raeisi P, Alikhani M, Mobinizadeh M. Fee for Service (FFS) payment on the basis of performance in Hasheminejad Hospital, Tehran. 2010. 3. Kazemi H. Salary and Fee System Tehran: Management Education Center;. 2002;in press. 4. Ebadifard Azar F, Badloo M, Rezaei E. Examining the relationship between Payment based on new manegerial approachfor hospital administration, Expectancy theory and job satisfaction in selected hospital staff of Tehran university of medical sciences in 2013. Hospital. 2015;13(4):123-32. 5. A Acheson, M. D. Gall. Supervision training. Translation: MR Behrangi. Tehran: kamal tarbiat.1376 6. Witter S, Ensor T, Thompson R, Jowett M. Health Economics for Developing Countries. A Practical Guide: MacMillan Education; 2000. 7. Karimi Saeed, the design of the new system of administration of hospitals: success and failure, the Journal of the School of Management and Medical Information, Issue 10, 11, Fall and Winter 1380 8. Polit DF, Beck CT. Nursing research: Principles and methods: Lippincott Williams & Wilkins; 2004. 9. Astrbrg, J. K., Qalitative research methods in social sciences, ed. A. Poorahmed and A. Shamae. 2006: Yazd University 10. Fatemeh Rajabi et al. , The final report analyzing the challenges and trends affecting health care system, Policy Council of the Ministry of Health and Medical Education and the National Institute of Health Research, Islamic Republic, 1390 11. Mohammadkarim Bahadori, Hossein Ibrahimipour, Ali Farzaneh,(2012), The challenges of supervision on providing health services from the viewpoint of the insurer: A qualitative study, International Journal of Collaborative Research on Internal Medicine & Public Health, Vol. 4 No. 9 12. Susan Bradley1, Francis Kamwendo2, Honorati Masanja3, Helen de Pinho4, achelWaxman4, Camille Boostrom1and Eilish McAuliffe1, District health managers’ perceptions of supervision in Malawi and Tanzania, http://www.human-resources-health.com/content/11/1/43