January 25, 2023

La retribució personalitzada de l'esforç del metge (2)

 Individual performance-based incentives for health care workers in Organisation for Economic Co-operation and Development member countries: a systematic literature review


Si considerem que cal introduir incentius basats en la qualitat, l'excel·lència i el valor aportat, aleshores hem de preguntar-nos per on començar. I el millor és fer una ullada al que fan els països amb els que ens volem comparar. Recentment ha sortit una revisió de l'estat de la qüestió que ajuda a fer-nos una idea de tot plegat. El resum és aquest:

Employing a behavioral psychology framework, we categorized PBI programs included in our review into four distinct reinforcement groups, including negative reinforcements for individual-level behavior (per output/outcome or overall targets) as well as positive reinforcement for individual-level behavior (per output/outcome or overall targets). In general, there was a level of ambiguity regarding the details of incentive activities and many studies did not present comparable results, but we strived to extract systematic information when possible, and compared and contrast odds ratios when available. We found PBI programs that utilized positive reinforcement methods are most commonly observed in OECD countries – with slightly more overall bonus incentives than payment per output or outcome achieved incentives. When comparing the outcomes from negative reinforcement methods with positive reinforcement methods, we found more evidence that positive reinforcement methods are effective at improving health care worker performance. Overall, just over half of the studies reported positive impacts, indicating the need for care in designing and adopting PBIs. 

Per tant, reforç positiu, o reforç negatiu i relacionar-ho amb l'output/resultat o amb objectius agregats. Dins l'article hi ha exemples concrets. I al final suggereixen molta atenció als detalls i als objectius que es pretenen, només la meitat han aportat impactes positius.


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