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. 2018 Sep 6;18(1):692.
doi: 10.1186/s12913-018-3472-4.

Improvement of the quality payment program by improving data reporting process: an action research

Shabnam Iezadi  1 , Jafar Sadegh Tabrizi  2 , Akbar Ghiasi  3 , Mostafa Farahbakhsh  4 , Kamal Gholipour  5   6
Affiliations

Improvement of the quality payment program by improving data reporting process: an action research

Shabnam Iezadi et al. BMC Health Serv Res. .

Abstract

Background: Successful implementation of pay-for-quality (P4Q) programs mostly depends upon a valid, timely, and reliable data about quality measures generated by providers, and interpreted by payers. The aim of this study was to establish a data reporting method for P4Q program through an action research.

Methods: Qualitative method was used to align theory with action through a three-cycle action research. The study was conducted in September 15, 2015 to March 15, 2017, in East-Azerbaijan, Iran. The purposeful sampling was used to select participants. The participants included healthcare providers, staff in district health centers (DHC), experts, and managers in the provincial primary health center (PPHC). Data was collected by interviews, focus group discussions, and expert panels. Content analysis was used to synthesize the data. In each step, decisions about data reporting methods were made through a consensus of expert panel members.

Results: The most important dimensions of data reporting method were data entry and accuracy, data reporting, data analysis and interpretations, the flexibility of method, and training. By establishment of an online data reporting system for the P4Q program, a major improvement was observed in the documentation of performance data, the satisfaction of health care providers and staff (e.g. either in DHCs or PPHC), improvement of the P4Q program and acceptance of the P4Q program by providers. Following the present study, the online system was expanded in Iran's public health system for data collection and estimating the amount of incentive payments in P4Q program. Moreover, more improvements were achieved by linking the system to EMRs and also, providing automated feedback to providers about their own performance.

Conclusions: A web-based computerized system with the capability of linking medical record and also its ability to provide feedback to healthcare providers was identified as an appropriate method of data reporting in the P4Q program from the viewpoints of participants in this study.

Keywords: Action research; Data reporting; Pay-for-performance; Pay-for-quality; Primary health center.

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Conflict of interest statement

Ethics approval and consent to participate

The study had been approved by the Ethics Committee of Tabriz University of Medical Sciences. Ethical Number: TBZMED.REC.1394.1169. Prior to the invitation of the participants leading author provided a short presentation of the project for potential participants during the series of office meetings. Given the nature of the study and considering the target population who were adults, were not vulnerable population, were mentally and physically healthy the type of the informed consent was optional by the ethics committee. Informed consent was obtained from all participants verbally; an attachment file was sent to potential participants along with invitation letter. An introduction to the study, objectives, ethical issues, questions, and short personal information of researchers were provided in the attached file (Additional file 2). Each participant who was willing to participate completed personal brief information form at the beginning of the sessions.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Data collection in four-step participatory action research
Fig. 2
Fig. 2
Main findings and actions
See this image and copyright information in PMC

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