Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.
Int J Health Serv. 2013;43(4):761-77. doi: 10.2190/HS.43.4.j.
Primary health care (PHC) is emphasized as the cornerstone of any health care system. Enhancing PHC performance is considered a strategy to enhance effective and equitable access to care. This study assesses the acceptability of and factors associated with quality reporting among PHC centers (PHCCs) in Lebanon. The managers of 132 Lebanese Ministry of Health PHCCs were surveyed using a cross-sectional design. Managers' willingness to report quality, participate in comparative quality assessments, and endorse pay-for-performance schemes was evaluated. Collected data were matched to the infrastructural characteristics and services database. Seventy-six percent of managers responded to the questionnaire, 93 percent of whom were willing to report clinical performance. Most expressed strong support for peer-performance comparison and pay-for-performance schemes. Willingness to report was negatively associated with the religious affiliation of centers and presence of health care facilities in the catchment area and favorably associated with use of information systems and the size of population served. The great willingness of PHCC managers to employ quality-enhancing initiatives flags a policy priority for PHC stakeholders to strengthen PHCC infrastructure and to enable reporting in an easy, standardized, and systematic way. Enhancing equity necessitates education and empowerment of managers in remote areas and those managing religiously affiliated centers.
初级卫生保健（PHC）被强调为任何卫生保健系统的基石。提高 PHC 的绩效被认为是增强有效和公平获得医疗服务的策略。本研究评估了黎巴嫩卫生部 PHC 中心（PHCC）质量报告的可接受性和相关因素。采用横断面设计对 132 家黎巴嫩卫生部 PHCC 的管理人员进行了调查。评估了管理人员报告质量、参与比较质量评估以及支持按绩效付费计划的意愿。收集的数据与基础设施特征和服务数据库相匹配。76%的管理人员对问卷做出了回应，其中 93%的人愿意报告临床绩效。大多数人强烈支持同行绩效比较和按绩效付费计划。报告的意愿与中心的宗教隶属关系以及集水区内医疗保健设施的存在呈负相关，与信息系统的使用和服务人群的规模呈正相关。PHCC 管理人员非常愿意采取质量改进措施，这为 PHC 利益相关者确定了政策重点，即加强 PHCC 基础设施，并以简单、标准化和系统的方式进行报告。要增强公平性，需要对偏远地区和管理宗教附属中心的管理人员进行教育和赋权。
