Basto-Pereira Miguel, Furtado Sara Isabel Félix, Silva Ricardo Jorge Pereira, Fachado González Francisco, Vara Fernandes Tito Manuel, Correia de Sousa Jaime, Yaphe John
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga , Portugal.
Eur J Gen Pract. 2015 Mar;21(1):52-7. doi: 10.3109/13814788.2014.907268. Epub 2014 May 20.
Performance indicators assessing the quality of medical care and linked to pay for performance may cause disagreement. Portuguese indicators included in recent health care reform are controversial.
To obtain consensus from opinion leaders in family medicine regarding the performance indicators for practice management used in the evaluation of Family Health Units in Portugal.
Eighty-nine specialists in primary care were invited to answer the following question in an online Delphi study: 'Which performance indicators should be assessed regarding the organization and management of clinical practice in primary care in Portugal?' A Likert scale was used to evaluate validity, reliability, feasibility and sensitivity to change. Twenty-seven experts participated in the second round and achieved a high degree of consensus. Eight categories were created for analysis.
The experts suggested the use of existing indicators as well as new indicators. Thirty-nine indicators suggested by the experts are currently in use in Portugal. The assessment of the number of clinical acts performed, the number of administrative acts, and evaluation of the clinical demographic profile achieved a high degree of consensus. The expert panel suggested fifty new indicators. Five categories of these new indicators had a high degree of consensus, and three categories had a low degree of consensus.
The expert panel recommended that performance indicators of practice management should first assess the quantity of clinical and administrative activities undertaken. These indicators must take into account the human and financial resources available to the clinic and its demographic context.
评估医疗质量并与绩效薪酬挂钩的绩效指标可能会引发争议。近期医疗改革中纳入的葡萄牙指标颇具争议。
就葡萄牙家庭健康单位评估中使用的实践管理绩效指标，征求家庭医学领域意见领袖的共识。
邀请89名初级保健专家在一项在线德尔菲研究中回答以下问题：“葡萄牙初级保健临床实践的组织与管理应评估哪些绩效指标？”采用李克特量表评估有效性、可靠性、可行性及对变化的敏感性。27名专家参与第二轮并达成高度共识。创建了八类进行分析。
专家们建议使用现有指标以及新指标。专家们提出的39项指标目前在葡萄牙正在使用。对所执行临床行为数量、行政行为数量以及临床人口统计学特征评估达成高度共识。专家小组提出了50项新指标。这些新指标中有五类达成高度共识，三类达成低度共识。
专家小组建议实践管理绩效指标应首先评估所开展临床和行政活动的数量。这些指标必须考虑诊所可用的人力和财力资源及其人口统计学背景。
