G2TT
来源类型Research Reports
规范类型报告
DOIhttps://doi.org/10.7249/RR1658
ISBN9780833097187
来源IDRR-1658-KRG
Health Sector Reform in the Kurdistan Region — Iraq: Primary Care Management Information System, Physician Dual Practice Finance Reform, and Quality of Care Training
C. Ross Anthony; Melinda Moore; Lee H. Hilborne; Anne Rooney; Scot Hickey; Youngbok Ryu; Laura Botwinick
发表日期2017
出版者RAND Corporation
出版年2017
页码116
语种英语
结论

Primary Care Management Information System

  • Most main primary health care centers serve too many people, and most sub-centers serve too few people.
  • Staffing by physicians, nurses, dentists, and pharmacists is uneven across the region. The data also identified centers where laboratory, X-ray, and/or other equipment should be repaired or replaced and where users should be trained.

Health Financing Reform: Physician Dual Practice

  • RAND conducted six focus groups with about 150 physicians during the week of December 8, 2013. The focus groups were designed to gather information about physician conduct and preferences related to working in both the public and private sectors.
  • Though the required workweek is 35 hours, and all physicians are paid for these 35 hours, most physicians spent only three or four hours per day working in the public sector. The remainder of the time was often spent working in the private sector, where pay is much higher.
  • Most physicians reported that they would prefer to work more than 35 hours per week and earn more pay through the public sector. The vast majority of physicians (over 80 percent) indicated that if pay were higher and public-sector resources were increased, they would prefer to work only in the public sector.

Creating a Sustainable Health Quality Infrastructure

  • A group of senior leaders participated in a 3.5-day education program created by RAND based on Joint Commission International quality standards.
  • Participants identified priorities for ongoing focus, including patient identification, hand hygiene, emergency cart standardization, safe surgery protocols, and completeness and standardization of medical record.
摘要
  • The authors recommend outsourcing the development of an online primary care management information system that can be accessed by all appropriate officials and relevant partners. The system should be user friendly and easy to access so that all appropriate users are able to enter updated data; generate tables, graphs, and maps; and use their data to inform primary care planning, resourcing, and management.
  • To resolve the problems associated with dual practice, the authors recommend full separation between the public and private sectors. In this option, physicians choose to work in only the public or private sector, with no private practice allowed in the evening for those who choose public service. Any plan should be phased in and coordinated so that the necessary inputs (facilities, medicines, and ancillary services) are available for physicians to do their work. The authors recommend full separation of public- and private-sector practice.
  • The development of a regional Quality and Patient Safety Institute based in Erbil that would use a train-the-trainer methodology would enable additional capacity-building. Hospital directors who have already demonstrated a commitment to leading quality and safety improvements should serve as co-faculty for future training, ultimately transitioning most or all training to institute staff.
主题Health Care Financing ; Health Care Organization and Administration ; Health Care Services Capacity ; The Kurdistan Region - Iraq ; Patient Safety ; Physicians ; Primary Care
URLhttps://www.rand.org/pubs/research_reports/RR1658.html
来源智库RAND Corporation (United States)
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条目标识符http://119.78.100.153/handle/2XGU8XDN/108637
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C. Ross Anthony,Melinda Moore,Lee H. Hilborne,等. Health Sector Reform in the Kurdistan Region — Iraq: Primary Care Management Information System, Physician Dual Practice Finance Reform, and Quality of Care Training. 2017.
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