بررسی اثربخشی اجرای طرح پرداخت مبتنی بر عملکرد در دانشگاه‌های علوم پزشکی استان سیستان و بلوچستان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، گروه حسابداری، دانشگاه سیستان و بلوچستان، سیستان و بلوچستان، ایران

2 کارشناس‌ارشد حسابداری، واحد زاهدان، دانشگاه آزاد اسلامی، سیستان و بلوچستان، ایران

3 کارشناس‌ارشد حسابداری، دانشگاه سیستان و بلوچستان، سیستان و بلوچستان، ایران

4 دانشجوی کارشناسی ارشد مدیریت منابع انسانی، دانشگاه سیستان و بلوچستان، سیستان و بلوچستان، ایران

چکیده

مقدمه: با توجه به الزام قانونی دستورعمل پرداخت مبتنی بر عملکرد و ضرورت ارتقاء کمیت و کیفیت خدمات در بخش سلامت، که بر نظام اقتصادی کشور نیز مؤثر است، پژوهش حاضر به بررسی اثربخشی طرح پرداخت مبتنی بر عملکرد می‌پردازد.   
روش پژوهش: این پژوهش از نظر هدف، کاربردی و از نظر ماهیت داده‌ها، توصیفی‌ تحلیلی با رویکرد پس‌رویدادی اسـت. جامعه آماری پژوهش شامل دانشگاه‌های علوم پزشکی استان سیستان و بلوچستان در بازه زمانی 1396-1389 (مشتمل بر پنج سال قبل و سه سال بعد از اجرای طرح پرداخت مبتنی بر عملکرد) است. در پژوهش حاضر برای گردآوری داده‌ها از برگه ارزیابی خدمات، تجزیه و تحلیل متون، گزارش‌های مدیریتی و داده‌های صورت‌های مالی استفاده و تجزیه‌وتحلیل آماری داده‌های مزبور از طریق رگرسیون چند متغیره انجام شده است.
یافته‌ها: نتایج بیانگر این است که بین اجرای طرح پرداخت مبتنی بر عملکرد با درآمد بیمارستان­ها، حضور فعال کارکنان غیرمؤظف و کیفیت ارائه خدمات رابطه مثبت و معنی‌دار وجود دارد اما بین اجرای این طرح و ضریب اشغال تخت فعال رابطه معنی­­داری مشاهده نشد.
نتیجه‌گیری: با توجه به مؤثربودن اجرای طرح پرداخت مبتنی بر عملکرد بر درآمد بیمارستان­ها می­توان اظهار داشت که این طرح تأثیر مثبتی بر عملکرد کارکنان بیمارستان‌ها داشته و موجب فعالیت بیشتر آنان در بیمارستان­ها، ارائه خدمات بهتر و در مجموع بهبود اثربخشی شده است. بنابراین، به مسئولان و مجریان طرح پرداخت مبتنی بر عملکرد در وزارت بهداشت، درمان و آموزش پزشکی پیشنهاد می­شود اجرای آن را به صورت گسترده­تر در سایر استان‌ها دنبال کنند.

کلیدواژه‌ها


عنوان مقاله [English]

Investigating the Effectiveness of Implementing Performance-Based Payment Plan on Sistan and Baluchestan University of Medical Sciences

نویسندگان [English]

  • A. Pifeh (Ph. D.) 1
  • R. Righi 2
  • H. Zarei 3
  • F. Soofi 4
1 Assistant Professor, Department of Accounting, Sistan and Baluchestan University, Sistan and Baluchestan, Iran
2 M. A. in Accounting, Zahedan Branch, Islamic Azad University, Sistan and Baluchestan, Iran
3 M. A. in Accounting, Sistan and Baluchestan University, Sistan and Baluchestan, Iran
4 M. A. Student in Human Resources Management, Sistan and Baluchestan University, Sistan and Baluchestan, Iran
چکیده [English]

Introduction: Due to the legal requirement of performance-based payment instruction and the necessity of improving the quantity and quality of services in the health sector affecting the national economic system, this study investigates the effectiveness of the performance-based payment plan.
Method: This research is applied in terms of purpose, and it is descriptive-analytic in terms of data with an ex post facto approach. The statistical population consisted of Sistan and Baluchestan Universities of Medical Sciences from 2010 to 2017 including the last five years ago and three years after the implementation of performance-based payment plan). Service evaluation form, text analysis, management reports, and financial statements data were used to collect data and then multivariate regression was used to analyze data.
Results: The results indicate that there is a positive and significant relationship between the implementation of the performance-based payment plan and the income of the hospitals, the active presence of non-executive staff and the quality of service provision, while there is no significant relationship between the implementation of this plan and active beds occupancy rate.
Conclusion: Considering the effectiveness of the implementation of performance-based payment plan on hospitals’ income it can be stated this plan has affected the hospitals staff performance positively. It has also resulted in increasing staff’s activities in hospitals, providing better services, and improving effectiveness as a whole.  Therefore, the providers of performance-based payment plan in the Ministry of Health and Medical Education are suggested to implement this plan in other provinces broadly.

کلیدواژه‌ها [English]

  • Effectiveness
  • Health Sector
  • Income
  • Performance-Based Payment Plan
  • Universities of Medical Sciences
1        Corley, E. A.; Bozeman, B.; Zhang, X.; and C. C. Tsai (2017). “The Expanded Scientific and Technical Human Capital Model: The Addition of a Cultural Dimension”, The Journal of Technology Transfer, Vol. 44, No. 3, pp. 1-19.
2        Ghanbari, M.; Yasemi, M. S.; and M. Abdehzadeh (2017). “Human Resource Accounting and Determining the Value of Human Capital and its Relationship with Information Management”, New Research in Management and Accounting, Vol. 3, No. 21, pp. 175-185. [In Persian]
3        Järlström, M.; Saru, E.; and S. Vanhala (2018). “Sustainable Human Resource Management with Salience of Stakeholders: A Top Management Perspective”, Journal of Business Ethics, Vol. 152, No. 3, pp. 703-724.
4        Masih Abadi, A.; Vahidyan, M.; and S. S.  Hashemi (2017). “A Review on Intellectual Capital Accounting Research”, Accounting Knowledge and Research, Vol. 13, No. 49, pp. 44-70. [In Persian]
5        Meyer, K. E. and K. R. Xin (2018). “Managing Talent in Emerging Economy Multinationals: Integrating Strategic Management and Human Resource Management”, The International Journal of Human Resource Management, Vol. 29, No. 11, pp. 1827-1855.
6        Rafi, A. N. M. and M. T. Hossain (2018). “Human Resource Accounting: Issues, Beneficial Proponents and Constraints”, Global Journal of Management and Business Research, Vol. 18, No. 3, pp. 9-13.
7        Raj, P. B. A. and S. Arputharaj (2018). “Human Resource Accounting: A Study on Advances in Concepts, Methods and Applications of Human Resources Accounting”, International Journal of Advance Research in Computer Science and Management Studies, Vol. 6, No. 2, pp. 21-32.
8        Askarian, M. (1999). Management of Human Capital, 2nd Edition, Tehran: Tarbiat Moalem University. [In Persian]
9        Seyed Javadein, S. R. (1994). “The Impact of Compensation in Maintaining Human Resources”, Journal of Management Knowledge, Vol. 26. No. 1, pp. 50-55. [In Persian]
10    Asili, Gh.; Ghadirian, A. A.; and S. Shovalpour (2008). “Investigating the Comprehensive System of Bonuses and Payment in the Knowledge-Based Organizations (A Case Study: Research Institute of Petroleum Industry)”, Management Studies in Development and Evolution, Vol. 15, No. 58, pp. 143-169. [In Persian]
11    McCausland, W. D.; Pouliakas, K.; and I. Theodossiou (2005). “Some are Punished and Some are Rewarded: A Study of the Impact of Performance Pay on Job Satisfaction”, International Journal of Manpower, Vol. 26, Nos. 7 and 8, pp. 636-659.
12    Roghani, A. R.; Abzari, M.; and I. Soltani (2012). “Identifying the Key Indicators of the Individulas Performance Assessment for the Bonuses Payment”, Journal of Management and Development Process, Vol. 25, No. 3, pp. 3-23. [In Persian]
13    Kahn, C. N.; Ault, T.; Potetz, L.; Walke, T.; Chambers, J. H.; and S. Burch (2015). “Assessing Medicare’s Hospital Pay-for-Performance Programs and whether they are Achieving their Goals”, Health Affairs, Vol. 34, No. 8, pp. 1281-1288.
14    Khajavi, Sh. and M. J. Etemadi Jouryabi (2017). “Corporate Social Responsibility and its Reporting”, Journal of Health Accounting, Vol. 4, No. 2, pp. 104-123. [In Persian]
15    Eichler, R. (2006). Can Pay for Performance Increase Utilization by the Poor and Improve the Quality of Health Services, 1st Edition, Washington D. C.: Center for Global Development.
16    Maslow, A. H. (1943). “A Preface to Motivation Theory”, Psychosomatic Med, Vol. 5, No. 1, pp. 85-92.
17    Cheng. C. W. (2007). “A Research Study of Fredrick Herzberg’s Motivator-Hygiene Theory on Continuing Education Participants In Taiwan”, Journal of American Academy of Business, Vol. 12, No. 1, pp. 186-195.
18    Porter, L. W. and E. E.  Lawler (1968). Managerial Attitudes and Performance, 3rd Edition,Homewood, IL: Irwin.
19    Stacy, J. A. (1965). Inequity in Social Exchanges, 2nd Edition, New York: Academic Press.
20    Vroom, V. H. and P. W. Yetton (1973). Leadership and Decision-Making, 1st Edition, Pittsburgh, PA: University of Pittsburgh Press.
21    Zaheri, M. A.; Amini, P.; and Z. Moshkani (2018). “Comparing the Cost of Services Provided by the Oncology Department in Traditional Costing and Activity-Based Costing Methods (A Case Study: Tohid Hospital in Kurdistan Province)”, Journal of Health Accounting, Vol. 7, No. 2, pp. 67-81. [In Persian]
22    Khajavi, Sh.; Etemadi Jouryabi, M.; and M. M. Etemadi Jouryabi (2017). “Investigating the Effect of Management Accounting Information on Organizational Performance of Governmental Hospitals in Gilan Province”, Journal of Health Accounting, Vol. 6, No. 2, pp. 67-89. [In Persian]
23    Ministry of Health and Medical Education (2014). “Performance-Based Payment Instruction in Hospitals Affiliated with the University/Faculties of Medicine and Health Services of the Ministry of Health and Medical Education”, Available at: http://p4p.behdasht.gov .ir. [Online][07 September 2018] [In Persian]
24    Esfandiar, S. (2016). Human Resource Management, 21th Edition, Tehran: Samt Publications. [In Persian]
25    Burin S.; Baan C.; and J. Struijs (2011). “Pay-for-Performance in Disease Management: A Systematic Review of the Literature”, BMC Health Services Research, Vol. 11, No. 1, p. 272.
26    Cromwell, J.; Trisolini, M.; Pope, G.; Mitchell, J.; and L. Greenwald (2011). Pay for Performance in Health Care: Methods and Approaches, 1st Edition, United States, North Carolina: Research Triangle Institute Press.
27    Abbasi, T.; Monourian, A.; and T. Reza Nejad (2016). “Identifying and Explaining the Obstacles upon Establishing a Performance-Based Payment System in Government Organizations”, Human Resource Management Researches, Vol. 9, No. 25, pp. 109-133. [In Persian]
28    Piekkola H. and B. Mahy (2005).  “Performance-Related Pay and Firm Performance in Finland”, International Journal of Manpower, Vol. 26, Nos. 7 and 8, pp. 619-635.
29    Cottini, E. and C.  Lucifora (2010).  Performance Pay and Financial Participation Today: A Comparison EU-US, 3nd Edition, Mimeo: Universita Cattolica di Milano.
30    Raeisi, P.; Alikhani, M.; and M. Mobinizadeh (2010). “Paying
Performance-Based Merit Pay of Shahid Hashemi Nejad Hospital in Tehran”, Health Management, Vol. 2, Nos. 1 and 2, pp. 27-36. [In Persian]
31    Jannati, A.; Kabiri, N.; Asghari Jafarabadi, M.; Pourasghari, B.; and B. Bayaz (2015). “Investigating the Imapct of Performance-Based Payment on the Efficiency of Laboratory of Imam Reza Training and Treatment Center in Tabriz”, Journal of Hospital, Vol. 14, No. 1, pp. 51-62. [In Persian]
32    Doran, T.; Fullwood, C.; Gravelle, H.; Reeves, D.; Kontopantelis, E.; Hiroeh, U.; and M. Roland (2006). “Pay-for-Performance Programs in Family Practices in the United Kingdom”, The New England Journal of Medicine, Vol. 355, No. 4, pp. 375-384.
33    Greengarten M. and M. Hundert (2006). “Individual Pay-for-Performance in Canadian Healthcare Organizations”, Healthcare Papers, Vol. 6, No. 4, pp. 57-61.
34     DeVaro, J. and J. S. Heywood (2017). “Performance Pay and Work-Related Health Problems: A Longitudinal Study of Establishments”, Industrial and Labor Relations Review, Vol. 70, No. 3, pp. 670-703.
35    Burgess, S.; Propper, C.; Ratto, M.; and E. Tominey (2017). “Incentives in the Public Sector: Evidence from a Government Agency”, The Economic Journal, Vol. 127, No. 605,pp. 1-41.
36    Damberg, C. L.; Elliott, M. N.; and B. A. Ewing (2015). “Pay-for-Performance Schemes that Use Patient and Provider Categories Would Reduce Payment Disparities”, Health Affairs, Vol. 34, No. 1, pp. 134-142.
37    Borghi, J.; Little, R.; Binyaruka, P.; Patouillard, E.; and A. Kuwawenaruwa (2015). “In Tanzania, the Many Costs of Pay-for-Performance Leave Open to Debate whether the Strategy is Cost-Effective”, Health Affairs, Vol. 34, No. 3, pp. 406-414.
38    Yip, W.; Powell-Jackson, T.; Chen, W.; Hu, M.; Fe, E.; Hu, M.; Jian, W.; Lu, M.; Han, W.; and W. C. Hsiao (2014). “Capitation Combined with Pay-for-Performance Improves Antibiotic Prescribing Practices in Rural China”, Health Affairs, Vol. 33, No. 3, pp. 502-510.
39    Werner, R. M. and R. A. Dudley (2009). “Making the ‘Pay’ Matter in Pay-for-Performance: Implications for Payment Strategies”, Health Affairs, Vol. 28, No. 5, pp. 1498-1508.
40    Sadeghi, Gh.; Adham, D.; Khalili, Z.; Panahi Toulesno, M.; Naseri, M.; Gholizadeh Nategh, A.; and M. Abazari (2017). Investigating the Status of Law Enforcement of Productivity Improvement of Clinical Staffs in Hospitals Affliated to Ardabil University of Medical Sciences”, Ardabil Health and Medical, Vol. 8, No. 2, pp.151-159. [In Persian]  
41    Ebadi Fardazar, F.; Arab, M.; Badlou, M.; and E. Rezaei (2014). “Investigating the Relationship between Payment Based on New Manegerial Approach for Hospital Administration, Expectancy Theory and Job Satisfaction in Selected Hospital Staff of Tehran University of Medical Sciences in 2013”, Journal of Hospital, Vol. 13, No. 4, pp. 123-132. [In Persian]
42    Nejabat, A. (2010). “Productivity and Payment System”, Journal of Strategy Development, Vol. 23, No. 1, pp. 149-164. [In Persian]
43    Ebadi, A. and M. Haddad Mobadelabadi (2007). “The Effectiveness of Payment Systems in Healthcare Organizations”, Management Monthly, Vol. 18, No. 1, pp. 84-86. [In Persian]
44    Karimi, A. and A. Nateghian (2001), “Medical Education and Self-Government of Training Hospitals”, Journal of Medical Education, Vol. 2, No. 1, pp. 7-23. [In Persian]
45    Aghajani, M.; Oliayeimanesh, A.; Manavi, S.; Roonasian, R.; Yousefvand, M.; Pouraghasy, L.; Maher, A.; Shahrami, A.; Cullivand, P.; Tabatabai, M.; Kermanchi, J.; Babaie, F.; Vaezi, H.; Zangan, M.; Dehghani, A.; and S. S. Hosseini (2019). “Investigating the Effectiveness and the Process of Implementing New System of Payment-Based Performance Compared to the New System of Managing Hospital in Development Plan of the Health System”, Journal of Hakim Health Research, Vol. 20, No. 4, pp. 213-225 [In Persian]  
46    Brown, M. P.; Sturman, M. C.; and M. J. Simmering (2003). “Compensation Policy and Organizational Performance: The Efficiency, Operational, and Financial Implications of Pay Levels and Pay Structure”, Academy of Management Journal, Vol. 46, No. 6, pp. 752-762.
47    Emami Meybodi, A. (2000). The Principles of Measuring Efficiency and Productivity, 2nd Edition,Tehran: Institute for the Study and Research of Commerce. [In Persian]
48    Rose, C. and W. Patril (1997). “Management Ownership and Firm Performance in Listed Danish Firms”, European Management Journal, Vol. 23, No. 5, pp. 542-553.
49    Soori, A. R.; Gharshasbi, A.; and B. Oryani (2007). “Comparative Comparison of the Efficiency of Commercial Banks in Iran Using the DEA and SFA Methods”, Journal of Modern Economics and Business, Vol. 3, No. 8, pp. 33-60. [In Persian]
50    Zahedan University of Medical Sciences (2014). Directive 6/100.  [In Persian]
51    Najafi Dolatabad, Sh.; Ahmadi Jahanabad, F.; Malekzadeh, J.; Z. Mohebi Nobandegani (2011). “Comparing Patientsʼ Satisfaction Hospitalized in Shahid Behesti Hospital of Yasouj City Before and After Modifications Made in Staff Merit Pay”, Iranian Journal of Nursing, Vol. 23, No. 68, pp. 39-46. [In Persian]
52    Badiee Aval, S.; Adel, A.; Hosseini, S. J.; Ebrahimipour, H.; and E. Askarzadeh (2019). “The Effect of Development Plan of the Health on the Performance Indicators in Hospitals of Mashhad University of Medical Sciences Using the Pabon Lasso Model”, Management Strategy for Health System, Vol. 3, No. 4, pp. 290-298. [In Persian] 
53    Kavoosi, Z.; Ghoodarzi, S.; and A. Almasiankia (2013). “Assessing the Efficiency of Hospitals Using the Pabon-Lasso Model in Lorestan University of Medical Sciences”, Journal of Payavard Salamat, Vol. 6, No. 5, pp. 365-375. [In Persian] 
54    Parasuraman, A.; Zeithaml, V. A.; and L. L. Berry (1988). “Servqual: A Multiple-Item Scale for Measuring Consumer Perceptions of Service Quality”, Journal of Retailing, Vol. 64, No. 1, pp. 1-12.
55    Mosadegh Rad, M. and M. Sokhanvar (2018). “Evaluating the Quality of Tehran’ Hospitals Services Using HEALTHQUAL Model”, Journal of Medical Council of Iran, Vol. 35, No. 1, pp. 9-19. [In Persian]
56    Øvretveit, J. (2009). Does Improving Quality Save Money, A Review of Evidence of which Improvements to Quality Reduce Costs to Health Service Providers, 2nd Edition,London: The Health Foundation.
57    Ebadi Fardazar, F.; Ansari, H.; and A. Rezapour (2002). “Investigating the Status of Daily Bed Occupancy Costs and Performance Indicators in Hospitals Selected by Iran University of Medical Sciences”, Journal of Health Management, Vol. 7, No. 18, pp. 37-44. [In Persian]
58    Khoshab, H.; Seyed Bagheri, S. H.; Piri, A.; Khoshab, M.; Mahdizadeh, M.; and A. Sayadi (2017). “Investigating the Law Enforcement of Productivity Improvement and Performance-Based Payment Plan on Patients’ Satisfaction Hospitalized in Governmental Hospitals of Kerman and Sistan and Balouchestan (South East of Iran) Hospitals in 2016”, Journal of Rafsanjan Universty of Medical Sciences, Vol. 16, No. 6, pp. 529-540. [In Persian]