Performance indicators in family health units: A progress report on health care reform
DOI:
https://doi.org/10.32385/rpmgf.v27i1.10818Keywords:
Reimbursement, Incentive, Quality Indicators, Health Care, Quality AssuranceAbstract
Performance indicators have been in use in Portugal for some time now for performance assessment and contractualisation in Family Health Units (USFs). It is important to consider both the quality of the performance indicator and its impact on the delivery of health care in general practice in order to improve performance assessment. When performance indicators assess only a limited area of clinical practice or set very high targets, they may limit the focus of clinical activities with possible negative consequences for patients. One of these consequences may be the replacement of Patient-Centred Medicine with Indicator- Based Medicine. In addition, there is poor scientific evidence for the use of some of the indicators and controversial usefulness of others. The difficulty of measuring some health outcomes can produce medicalisation, consumerism, and iatrogenic disease. In this paper, the authors present some suggestions for improving existing performance indicators. Further developments of related matters, such as the medical information system and contract schemes, are also proposed. Payment for performance should be based on indicators that produce better health outcomes for patients while respecting the principles of family medicine.Downloads
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