Quality Control

The previous post [Payment Mechanism] explains about the income source of a GP, and based on Forbes Magazine, health care professionals are among the highest paid occupation in US according to the data released by US Department of Labour in Occupational Employment and Wage Estimates, May 2009. This statistic puts surgeon as the highest paid occupation with anesthesiologist in the second notch of the list. With this condition, how the health system can manage the quality of care given to the patient by their doctors?

For this, several country have take some action in manipulating the GP salary so that GP performance quality is maintain to its maximum. UK is a country which pay their GP by monthly salary, but there is a new system called quality incentive which will be paid to the contracted GP according to the pay-for-performance mechanisms. In a paper written by Peter C. Smith and Nick York entitle Quality Incentive: The Case of UK General Practitioners stated that traditionally  GP income come from a mix of remuneration methods, including fee-for-service, capitation, salary, and capital and information technology (IT) but starting in April 2004 quality incentive will contribute up to 13% of the UK GP's income. The new incentive scheme uses 146 indicators of quality across seven areas of practice from clinical quality, practice organization to patient experience. UK government trying to accomplish a better quality control with better health status result at the patient's end.

Other than that, insurance company also can take action in maintaining the health care quality by putting a guideline to their contracted GP to perform clinical care accordingly and does not perform unnecessary procedure to the patient. This is called manage care and each insurance company has their own group of elite doctors in manage care which will assess the care given to that company's policyholder. Insurance company usually also give a list of essential drugs which can be prescribed to patient covered by that company. here it will help the patient from receiving unnecessary expensive drug where as cheaper yet same efficacy is available in the market.

Lastly, some hospital has their own committee that perform clinical audit to ensure that clinical care is done according to the latest evidence-based medicine and patient health care is handled correctly. This committee usually represented by the senior doctors in that practice. They are responsible to set the standard and collect the data from the current patient management in that practice, so that they can improve which area that need to be improved.