A Study on Physician Performance Measures for Financial Compensation in Academic Medical Centers

대학병원 의사들의 보상결정 기준으로서의 성과 측정지표에 대한 연구

An increasing number of hospitals are seeking for new or mixed compensation strategies to improve the productivity of their medical staff in the struggle to provide high quality medical services at low costs amid the economic hardship. To motivate physicians toward the right direction, it is necessary to effectively evaluate their performance that provides a basis for compensation. However, productivity has been historically difficult to measure, particularly for physicians in academic medical centers who are expected to engage in research, education, and patient care simultaneously. The objectives of this study were to define performance measures of physicians and clinical departments in academic medical centers. to examine correlations between the measures. and to investigate factors affecting the measures. The performance data of 212 faculty physicians in 17 clinical departments in two university teaching hospitals affiliated to one medical school during the fiscal year 1994 was used for analyses. Patient care revenue, net profit. and adjusted number of patients were defined to measure the performance in patient care. and number of articles published in academic journals and research grant were defined for research activities. Both individual physicians' performance measures and per physician measures of clinical departments were analyzed. All measures defined to evaluate individual physicians' performance were positively related to each other. Clinical department and rank of faculty position were statistically significant predictors of revenue. and hospital. clinical department. and rank were significant predictors of net profit. journal publication. and research grant. Patient care measures defined to evaluate clinical departments were related to each other. so were research measures. and no significant correlations were found between patient care measures and research measures. Also found were large differences in department. ranks when clinical departments were evaluated by absolute per physician performance measures and evaluated by annual rate of changes in performance measures. These findings suggest that departmental performance measures opposed to individual performance measures are relatively free from problems of factors affecting the performance measures that are not in control of clinical departments or individual physicians. Results from the correlation analysis of departmental performance measures indicates that measures of research performance should be included in the evaluation to promote research activities in academic medical centers.