A Survey of the Strengths of the Performance-Based Scheme in Selected Teaching Hospitals of Isfahan, Iran, in 2014: A Qualitative Study

Introduction: In the year 1995, the novel hospital administration plan (fee for service) was presented. Based on this plan, a percentage of specific revenues are allocated as a fee to the hospital staff. This plan was implemented in hospitals for 20 years. In early September 2104, the new guideline entitled the performance-based fee was designed with the aim of eliminating the deficiencies in the previous plan and implemented in hospitals in Isfahan, Iran. Therefore, the present study was performed with the aim of studying the strengths of the performance-based scheme in selected teaching hospitals of Isfahan in 2014. Method: This was a qualitative study. In-depth interviews were used to collect data. The study participants consisted of 11 middle managers and executive managers of university hospitals and university headquarters, faculty members, and hospital officials. The subjects were selected through purposive sampling method. All interviews were recorded and transcribed verbatim. The duration of the interviews varied between 30 to 60 minutes. Data analysis in this research was based on thematic analysis. Results: In this research, the 4 main strengths of "defining and developing appropriate guidelines, improving the monitoring system, improving the management information system, and organizing the fee payment system" were obtained. Conclusion: The results of the present study revealed the 4 main strengths of the performance-based scheme. Thus, in order for the health system to be effective, the strengths of the performance-based plan must be evaluated and used to reduce the dissatisfaction of hospital staff. Keywords: Hospital, Payment system, Executive managers, Fee for service