Original efficiency indices in PHC patient care

Abstract

Background. the ever-increasing needs and demands of patients, development of new treatments and health services together with limited financial, infrastructural and human resources require an increase in the efficiency of health care while minimizing the cost of this process. Raising cost-effectiveness at the level of individual physicians is a response to the limitations of healthcare resources and high physician involvement in the choice of diagnostics and treatment methods. Objectives. to develop efficiency indices that can be used in studies on doctors' efficiency in PhC patient care. Material and methods. the indices were developed following a pilot study at the Medical and Diagnostic Center in siedlce, Poland, literature analysis and expert consultations. they were based on Data envelopment analysis (Dea) methodology and focused on three operational areas: structure, process and outcome. the quality and reliability of the indices were tested on a group of PhC physicians. Results. 11 indices were developed: 1 index within quality of structure (patient population coverage), 7 indices within quality of process (efficiency of working time, efficiency of key appointments, efficiency of comprehensive medical consultations, efficiency of the number of basic and extended check-ups, percentage of pap smear tests, percentage of mammography screening tests, percentage of prophylactic cardiovascular screening tests) and 3 indices within quality of outcome (efficiency of the performance of health care plan, efficiency of the number if issued DILO cards, average years of life). Conclusions. the proposed indices worked well in practice, and in the future, a collective efficiency scale based on these indices is planned to be developed.