Linking physicians with quality efficiency, contribution and the supplementary payment of circulating capital in public hospitals: A proposal for auniversity hospital supplementary payment model

Performance-based remuneration is the remuneration system that is given to employees as reward or appreciation when corporate or individual goals are achieved. The purpose of this system is to give employees wages or additional payments according to their performance in business processes. performance-based salary can be given to the employees in the form of a direct salary or as an additional payment in addition to the fixed salary. This performance-based wage system is applied in almost all sectors as well as in health sector. Especially in public hospitals, health workers and physicians are given additional payment from revenue assets according to their performance in order to increase and encourage their motivation to work; doctors account for a large share of the distributed additional payment. Therefore, the focus of the study is on additional payment to doctors based on performance. Nowadays, the payment method, which is defined as performance-based additional payment system, has been developed on the basis of scoring of medical procedures. This system has the score of each medical procedure and the scores are determined by the relevant public authorities. Doctors earn points as a result of the medical procedures they perform, and these scores are distributed to doctors as money amounts in accordance with the calculation methods specified in the regulations. The performance evaluation here is performed only on the basis of the defined process scores without considering the performance and quality and efficiency criteria related to the health service processes. Since the system is not based on performance measurement based on scientific approaches, it receives serious criticism from both public sector and doctors. In this study, an alternative to the existing performance-based supplementary payment system applied in public hospitals, a model that measures doctors' performance based on more rational and scientific approaches, and takes into account the variables related to the contribution, quality and efficiency elements in health service processes has been developed and its applicability in public hospitals has been demonstrated. Keywords: Physician, Performance, Supplementary Payment