Evaluation of an international benchmarking initiative in nine eye hospitals.

Background: Benchmarking has become very popular among managers to improve quality in the private and public sector, but little is known about its applicability in international hospital settings.

Purpose: The purpose of this study was to evaluate the applicability of an international benchmarking initiative in eye hospitals.

Methodology: To assess the applicability, an evaluation frame was constructed on the basis of a systematic literature review.

Creating patient value in glaucoma care: applying quality costing and care delivery value chain approaches--a five-year case study in the Rotterdam Eye Hospital.

Purpose: The purpose of this paper is to explore in a specific hospital care process the applicability in practice of the theories of quality costing and value chains.

Design/methodology/approach: In a retrospective case study an in-depth evaluation of the use of a quality cost model (QCM) and the applicability of Porter's care delivery value chain (CDVC) was performed in a specific care process: glaucoma care over the period 2001 to 2006 in the Rotterdam Eye Hospital in The Netherlands.

Findings: The case study shows a reduction of costs per product by increasing the number of outpatient visits and surgery combined with a higher patient satisfaction.

Selecting effective incentive structures in health care: A decision framework to support health care purchasers in finding the right incentives to drive performance.

Background: The Ontario health care system is devolving planning and funding authority to community based organizations and moving from steering through rules and regulations to steering on performance. As part of this transformation, the Ontario Ministry of Health and Long-Term Care (MOHLTC) are interested in using incentives as a strategy to ensure alignment - that is, health service providers' goals are in accord with the goals of the health system. The objective of the study was to develop a decision framework to assist policymakers in choosing and designing effective incentive systems.

Increasing performance of health care services within economic constraints: working towards improved incentive structures.

There is increasing evidence that health care systems can create better value for money by improving performance and setting the right incentives. Worldwide this has led to an emergence of financial and non-financial incentive structures as a strategy to improve performance. The role of incentives is not only to motivate high performance through the alignment of results and rewards (financial/non-financial as well as direct/indirect) but also to enable health care providers to perform better by mitigating financial barriers that typically result from funding schemes.

Is there a business case for quality in The Netherlands? A critical analysis of the recent reforms of the health care system.

Major reforms of the health insurance system and reimbursement systems for care providers are currently taking place in The Netherlands. These market-oriented health care reforms will transform the current central supply-driven system to a system of managed competition both among health care insurers and care providers. The reforms are not systematically linked to the discussions about quality of care and together with consumers who might be more interested in lower premiums; they offer almost no incentive for health care insurers and providers to steer on quality.