ACCEPTABILITY OF QUALITY REPORTING AND PAY FOR PERFORMANCE AMONG PRIMARY HEALTH CENTERS IN LEBANON

• Published in: International journal of health services 2013-01, Vol.43 (4), p.761-777
• Main Authors: Saleh, Shadi S., Alameddine, Mohamad S., Natafgi, Nabil M.
• Format: Article
• Language: English
• Subjects: Acceptability; Attitude of Health Personnel; Education; Empowerment; Equality; Evaluation; Evaluation Studies as Topic; Flags; Health; Health care; Health Care in the Arab World: The Case of Lebanon; Health Care Surveys; Health Facility Administrators - psychology; Humans; Infrastructure; Lebanese; Lebanon; Managers; Medical service; Performance related pay; Population; Primary Health Care - economics; Primary Health Care - organization & administration; Primary Health Care - standards; Quality of Health Care; Questionnaires; Reimbursement, Incentive - economics; Reimbursement, Incentive - standards; Standardization
• ISSN: 0020-7314; 1541-4469
• 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-forperformance 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 peerperformance 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.