Opinions of Physicians and Nurses on Performance-Based Supplementary Payment System: A Qualitative Study

¹Afyonkarahisar University of Health Sciences, Faculty of Health Sciences, Department of Health Management, Afyon, Turkey
²Afyon Kocatepe University, Faculty of Economics and Administrative Sciences, Department of Business Administration, Afyon, Turkey

Aim: In the study, an evaluation was made by using Robert K. Merton�s theory of �Unexpected Effects of Purposeful Social Actions� and it was thought that unexpected effects might occur as well as expected results. In this sense, it is aimed to reveal the unexpected effects of the performance-based supplementary payment system on health workers.
Method: Qualitative research design was used in the study. The data of the study were obtained by semi-structured interview method with the participation of 18 nurses and six physicians working in a public and university hospital.
Results: Two main themes and seven sub-themes emerged in the study. The first theme is solution options for quota problems and consists of three sub-themes: borrowing, complaint, and acceptance. The second theme is the number of patients receiving care and service-quality balance, and its sub-themes are excessive workload, patient satisfaction, caring for quality, and conscientiousness.
Conclusion: There are criticisms of the performance-based supplementary payment system on the basis of existing health policies. In this study, in which the effects of the mentioned situation on healthcare professionals were examined, it was concluded that the system was insufficient in terms of both ethics and payments.

Keywords:

Hekim ve Hem�irelerin Performansa Dayal� Ek �deme Sistemine �li�kin G�r��leri: Nitel Bir Ara�t�rma

¹Afyonkarahisar Sa�l�k Bilimleri �niversitesi, Sa�l�k Bilimleri Fak�ltesi, Sa�l�k Y�netimi B�l�m�, Afyon, T�rkiye
²Afyon Kocatepe �niversitesi, �ktisadi ve �dari Bilimler Fak�ltesi, ��letme B�l�m�, Afyon, T�rkiye

Ama�: �al��mada, Robert K. Merton�un �Ama�l� Sosyal Eylemlerin Beklenmeyen Etkileri� kuram�ndan yararlan�larak bir de�erlendirme yap�lm�� ve beklenilen sonu�lar�n yan�nda beklenmeyen etkilerinin de ortaya ��kabilece�i d��ncesinden hareket edilmi�tir. Bu anlamda performansa dayal� ek �deme sisteminin sa�l�k �al��anlar� �zerindeki beklenmeyen etkilerinin neler olabilece�inin ortaya ��kar�lmas� ama�lanm��t�r.
Y�ntem: �al��mada nitel ara�t�rma deseni kullan�lm��t�r. Ara�t�rman�n verileri bir kamu ve �niversite hastanesinde �al��an 18 hem�ire ve 6 hekimin kat�l�m� ile ger�ekle�tirilen yar� yap�land�r�lm�� g�r��me y�ntemiyle elde edilmi�tir.
Bulgular: �al��mada iki ana tema ve yedi alt tema ortaya ��km��t�r. �lk tema kota sorunlar�na ili�kin ��z�m se�enekleri olup bor�lanma, �ik�yet, kabullenme �eklindeki �� alt temadan olu�maktad�r. �kinci tema ise hizmet alan hasta say�s�-kalite dengesi olup alt temalar� fazla i� y�k�, hasta memnuniyeti, kaliteyi �nemseme ve vicdani boyuttur.
Sonu�: Sa�l�k politikalar� temelinde performansa dayal� ek �deme sistemine y�nelik ele�tiriler bulunmakta olup bu durumun sa�l�k profesyonelleri �zerindeki etkilerinin incelendi�i bu �al��mada, sistemin hem etik hem de �demeler a��s�ndan yetersiz kald�� sonucuna ula��lm��t�r.

Anahtar Kelimeler:

Enver Samet �zkal, Belk�s �zkara. Opinions of Physicians and Nurses on Performance-Based Supplementary Payment System: A Qualitative Study. Journal of Health and Nursing Management. 2022; 9(3): 504-514

Corresponding Author: Enver Samet �zkal, T�rkiye