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Randomized Controlled Trial
. 2009 May;24(3):167-74.
doi: 10.1093/heapol/czp003. Epub 2009 Feb 18.

A novel method for measuring health care system performance: experience from QIDS in the Philippines

Orville Solon  1 , Kimberly Woo, Stella A Quimbo, Riti Shimkhada, Jhiedon Florentino, John W Peabody
Affiliations
Randomized Controlled Trial

A novel method for measuring health care system performance: experience from QIDS in the Philippines

Orville Solon et al. Health Policy Plan. 2009 May.

Abstract

Objectives: Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q was developed, implemented in hospitals in the Philippines and how it compares with typical measures.

Methods: Q consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q.

Results: Q was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2(1/2) years. We found Q to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled USD2133 or USD305 per assessment per site.

Conclusion: Q appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings.

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Figures

Figure 1
Figure 1
Change in structural measures versus Q* score at each successive semester compared to baseline in Intervention sites
See this image and copyright information in PMC

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