Health Care : Current Reviews

Health services performance agreements as a contractual tool for responsive health systems: The case of Qatar

5^th International Congress on Healthcare & Hospital Management

December 03-04, 2018 | Rome, Italy

Fadi El-Jardali

American University of Beirut, Lebanon

Posters & Accepted Abstracts: Health Care Current Reviews

Abstract:

Background: Strategy-based performance management is limited in the Eastern Mediterranean Region (EMR). Information on developing and implementing performance management initiatives in addition developing and implementing national hospital performance measurement is limited in the EMR. Evidence is not widely available on the evolution and impact of such initiatives in regulating the health sector and enhancing accountability. Qatar was one of the first countries in the EMR to report on the use of a performance management tool that aligns strategies, performance measurement, and accountability. This study covered: the selection, development, and implementation of standardized indicators across all healthcare providers and lessons learned for national scale-up of performance measurement activities. Methodology: Mixed-methods including tools development and pilot-testing, guided by performance management cycle with a focus on knowledge translation and key principles: feasibility; mandatory participation; participatory approach through steering committee. Public, private, and semi-governmental hospitals, primary healthcare centers and polyclinics participated in this initiative. Data was collected through (1) semi-structured interviews; (2) review of 4,982 existing indicators worldwide; (3) consensus surveys for selecting indicators; (4) capacity building and pilot surveys; and (5) one-year grace period assessed by questionnaire. Findings: The developed contracts mandate reporting 25 hospital and 15 primary healthcare indicators to the regulator, which delivers confidential benchmarking reports to providers. Scorecards were discussed with the regulator for evidence-informed policymaking. The approach uncovered system-related challenges and learning for public and private sectors: providers commended the participatory approach (82%) and indicated that contracts enabled collecting valid and timely data (64%) and improved healthcare quality (55%). Conclusion: This paper presents the methods and results of a performance management initiative from Qatar and discusses the valuable lessons of this approach. This experience suggests that development and use of strategy-based scorecards in contractual agreements can be effective if clear principles are applied early on.

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