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Assessment of physician performance in health sector

Yıl 2013, Sayı: 2, 81 - 99, 01.03.2013

Öz

Physicians, who are the most important human resources in health sector, act alone most of the time and they undertake the responsibility for health care outcomes. Physicians work in complex environments and they fall into teams and systems increasingly day by day. Physicians involvement in health care system and the increase in their contribution to quality of health care services including patient care in the last ten years has increased the emphasis on the measurement of physician performance. It was seen that physician performance assessment approaches have mainly focused on the measurement of clinical performance. In this study, approaches in physician performance assessment are classified as clinical/ behavioural approaches and objective/ subjective measurement approaches. In this framework, it has been expected that multi dimensional physician performance assessment methods would become more popular in the future.

Kaynakça

  • • ADAIR, J.G., (1984), ‘The Hawthorne Effect : A Reconsideration of The Methodological Artifact’, Journal of Applied Psychology, 69(2), 334- 345
  • • BARROWS, H.S., (1993), ‘An Overview of The Uses of Standardized Patients for Teaching and Evaluating Clinical Skills’, Academic Medicine, 68(6), 443-451
  • • BARUTÇUGİL, İ., (2002), Performans Yönetimi, Kariyer Yayıncılık İletişim Ltd. Şti
  • • BERGUER, R., (1999), ‘Surgery and Ergonomics’, Archieves of Surgery, 134(9), 1011-1016
  • • BERTAKIS, K.D., HELM, L.J., CALLAHAN, E. J., AZARI, R. and ROBBINS, J., (1995), ‘The Influence of Gender on Physician Practice Style’, Medical Care, 33(4), 407-416
  • • DILLNER, L., (1995), Manchester Tackles Failure Rate Of Asian Students, BMJ (British Journal of Medicine), 310:209
  • • DONABEDIAN, A., (2000), ‘Evaluating Physician Competence’, Bulletin of The World Health Organization, 78(6), 857-860
  • • DUBINSKY, I., JENNINGS, K., GREENGARTEN, M., and BRANS, A., (2010), ‘360-Degree Physician Performance Assessment’, Healthcare Quarterly, 13(2), 71-76
  • • ELÇİN, M., ODABAŞI, O. ve SAYEK, İ., (2005), ‘Yapılandırılmış Objektif Klinik Sınavlar’, Hacettepe Tıp Dergisi, Editöryal 36:1-2
  • • ELÇİN, M., ODABAŞI, O., TURAN, S., SİNCAN, M., ve BAŞUSTA, N.B., (2010), ‘Tıp Eğitiminde İletişim Becerilerinin Standart Hastalar ve Yapılandırılmış Değerlendirmelerle Geliştirilmesi’, Hacettepe Tıp Dergisi, 41 (4), 219- 230
  • • ERGİN, G., (2009), ‘Çalışanların Ücretlendirilmesi: Sağlık Kurumlarında Çalışanların Ücret Sistemini Değerlendirmelerine İlişkin Bir Araştırma’, Doktora Tezi, Hacettepe Üniversitesi, Sağlık Kurumları Yönetimi, A.B.D., Ankara
  • • ESPTEIN, R.M. and HUNDERT, E.M., (2002), ‘Defining and Assessment Professional Competence’, Journal of American Medical Association, 287(2), 226-235
  • • EVANS, R., ELWYN, G. and EDWARDS, A., (2004), ‘Review of Instruments for Peer Assessment of Physicians’, BMJ (British Journal of Medicine), 328, 1-5
  • • FARMER, E.A., BEARD, J.D., DAUPHINEE, W.D., LADUCA, T. and MANN, K.V., (2002), ‘Assessing The Performance of Doctors In Teams and Systems’, Medical Education, 36: 942-948
  • • GORDON, R., (2012), ‘The Vanishing Physician Scientist: A Critical Review and Analysis’, Accountability In Research, 19, 89-113
  • • Hacettepe Üniversitesi 2011-2012 Öğretim Yılı İyi Hekimlik Uygulamaları Kılavuzu, www.tip.hacettepe.edu.tr/ekler/pdf/rehber12
  • pdf
  • • HALL, J.A., PALMER, H., ORAV, E.J., HARGRAVES, J.L., WRIGHT, E.A. and LOUIS T.A., (1990), ‘Performance Quality, Gender and Professional Role’, Medical Care, 28(6), 489-501
  • • HAYS, R.B., DAVIES H.A., BEARD, J.D., CALDON, L.J.M., FARMER, E.A., FINUCANE, P.M., MCCRORIE, P., NEWBLE, D.I., SCHUWIRTH, L.W.T. and SIBBALD, G.R. (2002), ‘Selecting Performance Assessment Methods for Experienced Physicians’, Papers from the 10th Cambridge Conference, Medical Education, 36, 910-917
  • • KAIGAS, T., (2000), ‘Assessment of The Performance of Practicing Physicians In Canada’, 5th International Medical Workforce Conference, Sydney, 101-118
  • • KIM, C., MCEWAN, L.N., GERZOFF, R.B., MARRERO, D.G., MANGIONE, C.M., SELBY J.V. and HERMAN, W.H., (2005), ‘Is Physician Gender Associated With The Quality of Diabetes Care?’, Diabetes Care, 28(7), 1594-1598
  • • KOPELOW, M.L., SCHANBL, G.K., HASSARD, T.H., TAMBLYN, R.M., KLASS, D.J., BEAZLEY, G., HECHTER, F. and GROTT, M., (1992), ‘Assessment of Performance In The Office Setting With Standardized Patients’, Academic Medicine, 67(10), 19-21
  • • KUTANİS, R.Ö., TUNÇ, T. ve TUNÇ, M., (2011), ‘Tıpta Uzmanlık Eğiticileri ve Uzmanlık Öğrencileri Tıpta Uzmanlık Sınavı’nı (TUS) Nasıl Algılıyor?’, Kuram ve Uygulamada Eğitim Bilimleri, 11(4), 1992-2004
  • • LOCKYER, J., (2003), ‘Multisource Feedback In The Assessment of Physician Competencies’, The Journal of Continuing Education In The Health Professions, 23, 4-12
  • • LOCKYER, J.M. and VIOLATO, C., (2004), ‘An Examination of The Appropriateness of Using A Common Peer Assessment Instrument To Assess Physician Skills Across Specialties’, Academic Medicine, 79(10), 5-8
  • • MARSON, D.C., HAWKINS L., MCINTURFF, B. and HARRELL, L.E., (1997), ‘Cognitive Models That Predict Physician Judgements of Capacity to Consent In Mild Alzheimer’s Disease’, Journal of American Geriatrics Society, 45(4), 458-464
  • • MCMASTER, F.R. and HENG, B.H., (2007), ‘Measuring Physician Performance: A Review of The Literature, Health Technology Assessment, No: 1003, 1-3
  • • MIDIK, Ö., ve KARTAL, M., (2010), ‘Simülasyona Dayalı Tıp Eğitimi’, Marmara Medical Journal, 23(3), 389-399
  • • MILLER, G.E., (1990), ‘The Assessment of Clinical Skills/Competence/ Performance’, Academic Medicine, 65(9), 63-67
  • • MISCH, D.A., (2002), ‘Evaluating Physician’s Professionalism and Humanism: The Case for Humanism “Connoisseur”, Academic Medicine, 77(6), 489-495
  • • MOLEMA, J.J.W., GROOTHUIS, S., BAARS, I.J., KLEINSCHIPHORST, M., LEERS, E.G.E., HASMAN, A. and MERODE, G.G., (2007), ‘Health Care System Design and Parttime Working Doctors’, Health Care Management Science, 10: 365-371
  • • MORGAN, L., (2012), ‘Results-Based Financing for Health: Performance Incentives in Global Health: Potential and Pitfalls’, Feature, The World Bank, 1-6
  • • NONNOMAKER, L., (2000), ‘Women Physicians In Academic Medicine’, The New England Journal of Medicine, 342, 399-405
  • • OVEREEM, K.,WOLLERSHEIM, H.C., ARAH, O. A., CRUIJSBERG, J.K., GROL, R. and LOMBARTS, K., (2012) ‘Evaluation of Phsyicians’ Professional Performance: An Interative Development and Validation Study of Multisource Feedback Instruments’, BMC Health Services, 12:80
  • • SAĞLIK BAKANLIĞI, ‘Sağlıkta Yönetici ve Birim Performansı’, T.C. Sağlık Bakanlığı Performans Kalite Geliştirme Daire Başkanlığı, Şubat 2012
  • • SANAZARO, P.J. and WILLIAMSON, J.W., (1970), ‘Physician Performance and It’s Effects on Patient’s A Classification Based on Reports by Internists, Surgeons, Pediatricians and Obstetricians’, Medical Care, 8(4), 299-308
  • • ŞAHİN, H., ve SAÇAKLIOĞLU, F., (1999), “Evaluation Of Practitioners’ Apropriate Drug Prescribing Behaviour On Written Simulated Cases In Bornova Health District”, 7. Annual Meeting of ESOP/Ankara (Özet Kitabı, s.49)
  • • VALLEVAND, A.L.C., (2008), ‘Realibility, Validity and Sources of Errors In Assessing Physician Performance In An Objective Structured Clinical Examination: A Generalizability Theory Analysis’, Master Thesis, University of Calgary
  • • WEISSMAN, J.S., HASNAIN-WYNIA, R., WEINICK, R.M., KANG, R., VOGELI, C., IEZZONI, L., and LANDRUM, M.B., (2012), ‘Pay-for Performance Programs To Reduce Radical/Ethnic Disparities : What Might Different Designs Achieve?’, Journal of Health Care for Poor and Underserved, 23, 144- 160
  • • WHO (WORLD HEALTH ORGANIZATION), (2011), ‘Transformative Scale Up Of Health Professional Education’, www.who.int/hrh
  • • WOOLF, K., POTTS, H.W.W. and MCMANUS, I.C., (2011), ‘Ethnicity and Academic Performance In U.K. Trained Doctors and Medical Students: Systematic Review and Meta-Analysis’, BMJ (British Medical Journal), 342, 1-14
  • • YILMAZ, F.N., (2012), ‘İletişim Becerileri İstasyonundan Elde Edilen Öz Değerlendirme ve Puanlayıcı Değerlendirmelerinin Karşılaştırılması’, Eğitim ve Öğretim Araştırmaları Dergisi, 1(2):357-363.

Sağlık sektöründe hekim performansının değerlendirilmesi

Yıl 2013, Sayı: 2, 81 - 99, 01.03.2013

Öz

Sağlık sektöründe en önemli insan kaynaklarından birisi olan hekimler çoğu zaman tek başlarına çalışarak sağlık ile ilgili pek çok sonucun sorumluluğunu üstlenmektedirler. Çalışmalarını son derece karmaşık bir ortamda sürdüren hekimler gün geçtikçe takımlar ve sistemler içerisine daha fazla dahil olmaktadırlar. Son on yıl içerisinde hekimlerin sağlık sistemi ile entegrasyonu ve başta hasta bakımı olmak üzere sağlık hizmetlerinde kalite artışına vermiş oldukları katkının artışı hekim performansının ölçümüne olan ilgiyi artırmıştır. Hekim performansının ölçümü ile ilgili yaklaşımların ağırlıklı olarak klinik performans ölçümüne odaklandıkları görülmektedir. Bu çalışmada hekim performansı ölçümü konusundaki yaklaşımlar; klinik ve davranışlar performans ölçümü yaklaşımları ile objektif ve subjektif performans ölçümü yaklaşımları olmak üzere sınıflandırılarak incelenmiştir. Bu çerçevede gelecekte hekim performansının ölçümü konusunda çok boyutlu yaklaşımların ön plana çıkacağı düşünülmektedir.

Kaynakça

  • • ADAIR, J.G., (1984), ‘The Hawthorne Effect : A Reconsideration of The Methodological Artifact’, Journal of Applied Psychology, 69(2), 334- 345
  • • BARROWS, H.S., (1993), ‘An Overview of The Uses of Standardized Patients for Teaching and Evaluating Clinical Skills’, Academic Medicine, 68(6), 443-451
  • • BARUTÇUGİL, İ., (2002), Performans Yönetimi, Kariyer Yayıncılık İletişim Ltd. Şti
  • • BERGUER, R., (1999), ‘Surgery and Ergonomics’, Archieves of Surgery, 134(9), 1011-1016
  • • BERTAKIS, K.D., HELM, L.J., CALLAHAN, E. J., AZARI, R. and ROBBINS, J., (1995), ‘The Influence of Gender on Physician Practice Style’, Medical Care, 33(4), 407-416
  • • DILLNER, L., (1995), Manchester Tackles Failure Rate Of Asian Students, BMJ (British Journal of Medicine), 310:209
  • • DONABEDIAN, A., (2000), ‘Evaluating Physician Competence’, Bulletin of The World Health Organization, 78(6), 857-860
  • • DUBINSKY, I., JENNINGS, K., GREENGARTEN, M., and BRANS, A., (2010), ‘360-Degree Physician Performance Assessment’, Healthcare Quarterly, 13(2), 71-76
  • • ELÇİN, M., ODABAŞI, O. ve SAYEK, İ., (2005), ‘Yapılandırılmış Objektif Klinik Sınavlar’, Hacettepe Tıp Dergisi, Editöryal 36:1-2
  • • ELÇİN, M., ODABAŞI, O., TURAN, S., SİNCAN, M., ve BAŞUSTA, N.B., (2010), ‘Tıp Eğitiminde İletişim Becerilerinin Standart Hastalar ve Yapılandırılmış Değerlendirmelerle Geliştirilmesi’, Hacettepe Tıp Dergisi, 41 (4), 219- 230
  • • ERGİN, G., (2009), ‘Çalışanların Ücretlendirilmesi: Sağlık Kurumlarında Çalışanların Ücret Sistemini Değerlendirmelerine İlişkin Bir Araştırma’, Doktora Tezi, Hacettepe Üniversitesi, Sağlık Kurumları Yönetimi, A.B.D., Ankara
  • • ESPTEIN, R.M. and HUNDERT, E.M., (2002), ‘Defining and Assessment Professional Competence’, Journal of American Medical Association, 287(2), 226-235
  • • EVANS, R., ELWYN, G. and EDWARDS, A., (2004), ‘Review of Instruments for Peer Assessment of Physicians’, BMJ (British Journal of Medicine), 328, 1-5
  • • FARMER, E.A., BEARD, J.D., DAUPHINEE, W.D., LADUCA, T. and MANN, K.V., (2002), ‘Assessing The Performance of Doctors In Teams and Systems’, Medical Education, 36: 942-948
  • • GORDON, R., (2012), ‘The Vanishing Physician Scientist: A Critical Review and Analysis’, Accountability In Research, 19, 89-113
  • • Hacettepe Üniversitesi 2011-2012 Öğretim Yılı İyi Hekimlik Uygulamaları Kılavuzu, www.tip.hacettepe.edu.tr/ekler/pdf/rehber12
  • pdf
  • • HALL, J.A., PALMER, H., ORAV, E.J., HARGRAVES, J.L., WRIGHT, E.A. and LOUIS T.A., (1990), ‘Performance Quality, Gender and Professional Role’, Medical Care, 28(6), 489-501
  • • HAYS, R.B., DAVIES H.A., BEARD, J.D., CALDON, L.J.M., FARMER, E.A., FINUCANE, P.M., MCCRORIE, P., NEWBLE, D.I., SCHUWIRTH, L.W.T. and SIBBALD, G.R. (2002), ‘Selecting Performance Assessment Methods for Experienced Physicians’, Papers from the 10th Cambridge Conference, Medical Education, 36, 910-917
  • • KAIGAS, T., (2000), ‘Assessment of The Performance of Practicing Physicians In Canada’, 5th International Medical Workforce Conference, Sydney, 101-118
  • • KIM, C., MCEWAN, L.N., GERZOFF, R.B., MARRERO, D.G., MANGIONE, C.M., SELBY J.V. and HERMAN, W.H., (2005), ‘Is Physician Gender Associated With The Quality of Diabetes Care?’, Diabetes Care, 28(7), 1594-1598
  • • KOPELOW, M.L., SCHANBL, G.K., HASSARD, T.H., TAMBLYN, R.M., KLASS, D.J., BEAZLEY, G., HECHTER, F. and GROTT, M., (1992), ‘Assessment of Performance In The Office Setting With Standardized Patients’, Academic Medicine, 67(10), 19-21
  • • KUTANİS, R.Ö., TUNÇ, T. ve TUNÇ, M., (2011), ‘Tıpta Uzmanlık Eğiticileri ve Uzmanlık Öğrencileri Tıpta Uzmanlık Sınavı’nı (TUS) Nasıl Algılıyor?’, Kuram ve Uygulamada Eğitim Bilimleri, 11(4), 1992-2004
  • • LOCKYER, J., (2003), ‘Multisource Feedback In The Assessment of Physician Competencies’, The Journal of Continuing Education In The Health Professions, 23, 4-12
  • • LOCKYER, J.M. and VIOLATO, C., (2004), ‘An Examination of The Appropriateness of Using A Common Peer Assessment Instrument To Assess Physician Skills Across Specialties’, Academic Medicine, 79(10), 5-8
  • • MARSON, D.C., HAWKINS L., MCINTURFF, B. and HARRELL, L.E., (1997), ‘Cognitive Models That Predict Physician Judgements of Capacity to Consent In Mild Alzheimer’s Disease’, Journal of American Geriatrics Society, 45(4), 458-464
  • • MCMASTER, F.R. and HENG, B.H., (2007), ‘Measuring Physician Performance: A Review of The Literature, Health Technology Assessment, No: 1003, 1-3
  • • MIDIK, Ö., ve KARTAL, M., (2010), ‘Simülasyona Dayalı Tıp Eğitimi’, Marmara Medical Journal, 23(3), 389-399
  • • MILLER, G.E., (1990), ‘The Assessment of Clinical Skills/Competence/ Performance’, Academic Medicine, 65(9), 63-67
  • • MISCH, D.A., (2002), ‘Evaluating Physician’s Professionalism and Humanism: The Case for Humanism “Connoisseur”, Academic Medicine, 77(6), 489-495
  • • MOLEMA, J.J.W., GROOTHUIS, S., BAARS, I.J., KLEINSCHIPHORST, M., LEERS, E.G.E., HASMAN, A. and MERODE, G.G., (2007), ‘Health Care System Design and Parttime Working Doctors’, Health Care Management Science, 10: 365-371
  • • MORGAN, L., (2012), ‘Results-Based Financing for Health: Performance Incentives in Global Health: Potential and Pitfalls’, Feature, The World Bank, 1-6
  • • NONNOMAKER, L., (2000), ‘Women Physicians In Academic Medicine’, The New England Journal of Medicine, 342, 399-405
  • • OVEREEM, K.,WOLLERSHEIM, H.C., ARAH, O. A., CRUIJSBERG, J.K., GROL, R. and LOMBARTS, K., (2012) ‘Evaluation of Phsyicians’ Professional Performance: An Interative Development and Validation Study of Multisource Feedback Instruments’, BMC Health Services, 12:80
  • • SAĞLIK BAKANLIĞI, ‘Sağlıkta Yönetici ve Birim Performansı’, T.C. Sağlık Bakanlığı Performans Kalite Geliştirme Daire Başkanlığı, Şubat 2012
  • • SANAZARO, P.J. and WILLIAMSON, J.W., (1970), ‘Physician Performance and It’s Effects on Patient’s A Classification Based on Reports by Internists, Surgeons, Pediatricians and Obstetricians’, Medical Care, 8(4), 299-308
  • • ŞAHİN, H., ve SAÇAKLIOĞLU, F., (1999), “Evaluation Of Practitioners’ Apropriate Drug Prescribing Behaviour On Written Simulated Cases In Bornova Health District”, 7. Annual Meeting of ESOP/Ankara (Özet Kitabı, s.49)
  • • VALLEVAND, A.L.C., (2008), ‘Realibility, Validity and Sources of Errors In Assessing Physician Performance In An Objective Structured Clinical Examination: A Generalizability Theory Analysis’, Master Thesis, University of Calgary
  • • WEISSMAN, J.S., HASNAIN-WYNIA, R., WEINICK, R.M., KANG, R., VOGELI, C., IEZZONI, L., and LANDRUM, M.B., (2012), ‘Pay-for Performance Programs To Reduce Radical/Ethnic Disparities : What Might Different Designs Achieve?’, Journal of Health Care for Poor and Underserved, 23, 144- 160
  • • WHO (WORLD HEALTH ORGANIZATION), (2011), ‘Transformative Scale Up Of Health Professional Education’, www.who.int/hrh
  • • WOOLF, K., POTTS, H.W.W. and MCMANUS, I.C., (2011), ‘Ethnicity and Academic Performance In U.K. Trained Doctors and Medical Students: Systematic Review and Meta-Analysis’, BMJ (British Medical Journal), 342, 1-14
  • • YILMAZ, F.N., (2012), ‘İletişim Becerileri İstasyonundan Elde Edilen Öz Değerlendirme ve Puanlayıcı Değerlendirmelerinin Karşılaştırılması’, Eğitim ve Öğretim Araştırmaları Dergisi, 1(2):357-363.
Toplam 42 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Songül Çınaroğlu Bu kişi benim

Yayımlanma Tarihi 1 Mart 2013
Gönderilme Tarihi 16 Ağustos 2014
Yayımlandığı Sayı Yıl 2013 Sayı: 2

Kaynak Göster

APA Çınaroğlu, S. (2013). Sağlık sektöründe hekim performansının değerlendirilmesi. Verimlilik Dergisi(2), 81-99.

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