An AHP model for bringing experts to consensus on medical payment standards

Abstract

Many countries with health insurance systems conduct periodic payment standards reform. How to reach consensus in setting payment standards among different specialties with different agendas has become a critical issue. The purpose of this study is to construct an analytic hierarchy process (AHP) model to obtain judgments from experts about the importance of “factors related to establishing payment standards in the national health insurance program”. Under this goal, the first tier contains four evaluation aspects, and the second tier contains sixteen evaluation criteria divided into four groups. The AHP model was then used to collect and combine the opinions of experts through an empirical study. The results can be directly used to formulate standard values as the basis for establishing payment standards. The results of our study strongly support that an AHP model is effective in forming a consensus among surgical specialists.

Keywords

National Health Insurance / Analytic Hierarchy Process / payment standards

References

[1] Chapple A., Rogers A.. Explicit guidelines for qualitative research: a step in the right direction, a defence of the soft option, or a form of sociological imperialism?. Family Practice, 1998, 15: 556-561.

[2] Giacomini M.K., Cook D.J.. Users’ guides to the medical literature, XXIII: qualitative research in health care — A, are the results of the study valid?. Journal of the American Medical Association, 2000, 284: 357-362.

[3] Grimaldi P.L.. Medicare fees for physician services are resource-based. Journal of Health Care Finance, 2002, 28: 88-104.

[4] Gupta U.G., Clarke R.E.. Theory and applications of the Delphi technique: a bibliography (1975–1994). Technological Forecasting and Social Change, 1996, 53: 185-211.

[5] Harris-Shapiro J.. RBRVS revisited. Journal of Health Care Finance, 1998, 25: 49-54.

[6] Hoddinott P., Pill R.. A review of recently published qualitative research in general practice: more methodological questions than answers?. Family Practice, 1997, 14: 313-319.

[7] Hsiao W.C., Braun P., Dunn D., et al. Resource-based relative values, an overview. JAMA, 1988, 260: 2347-2352.

[8] Hsiao W.C., Braun P., Dunn D., et al. Special report: results and policy implications of the resource-based value study. New England Journal of Medicine, 1988, 319: 881-888.

[9] Jegers M., Kesteloot K., Graeve D.D., et al. A typology for provider payment systems in health care. Health Policy, 2002, 60: 255-273.

[10] Jones R.. Why do qualitative research?. British Medical Journal, 1995, 311: 2

[11] Malterud Q.K.. Qualitative research: standards, challenges, and guidelines. The Lancet, 2001, 358: 483-488.

[12] Pope C., Mays N.. Qualitative research: reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health care services research. British Medical Journal, 1995, 311: 42-45.

[13] Rotarius T.. An RBRVS approach to financial analysis in health care organizations. The Health Care Manager, 2001, 19: 17-23.

[14] Saaty T. L.. A scaling method for priorities in hierarchical structures. Journal of Mathematical Psychology, 1977, 15: 234-281.

[15] Saaty T. L.. The Analytic Hierarchy Process, 1980, New York: McGraw-Hill.

[16] Schackleford J.L.. Measuring productivity using RBRVS cost accounting. Health Care Financial Management, 1999, 53: 67-69.