Pay for performance does not translate to quality patient care. Quality is about efficiency and effectiveness. This can be measured with the type of care provided as well as the availability of other health care determinants such as accessibility, equity, reliability, as well as cost effectiveness. The essence of this paper is to argue against pay for performance.
For a service to be defined as of quality, both the client and the provider should be satisfied (Eijkenaar et al., 2013). Performance pay refers to the rewarding a provider for high value, activity, or meeting the targets (Michael, 2012). However, good results may have been contributed by many other external factors that could not be measured. Pay for performance does not necessarily change health care provider’s behaviour; thus, it is short-lived (Michael, 2012).
Achieving necessary targets or outcomes without improving the processes may not be a sustainable measure for patient care experience. For that reason, pay for performance only improves the outcomes whereas overall patient care involves a whole health system (Michael, 2012). This approach may be useful in private setup to evaluate the value of cost but may not apply in primary care where some factors may contribute to quality patient care (Michael, 2012). The measurement may not necessarily include what was happening before as long as the current target is achieved in some private sectors. A comparison of the before as a quality improvement indicator of what is current and putting measures in place to achieve the target would provide evidence-based results.
In summary, overall care of patient experience should be based on all health care dimensions. These include human resources (health workforce), infrastructure, leadership, performance measurement, and feedback. Additionally, quality of care provided must be based on client, stakeholder involvement, and effective financing.
References
Eijkenaar, F., Emmert, M., Scheppach, M., & Schöffski, O. (2013). Effects of pay for performance in health care: a systematic review of systematic reviews. Health Policy, 110(2), 115-130.
Michael, W. (2012). Pay-for-performance programs-do they improve the quality of primary care? Reprinted from Australian Family Physician 41(12), 989-991.
