An Artifact for Evaluating the Quality of Health Service Providers: Evidence From Brazil

Lúcia Helena da Silva Mendes, Luiz Cláudio Sampaio Mendes, Lilian Lucy dos Santos, Carlos Otávio Senff, Claudimar Pereira da Veiga, Luiz Carlos Duclós
2018 Inquiry: The Journal of Health Care Organization, Provision, and Financing  
The aim of this article is to present an artifact for evaluating the quality and performance of service providers in the field of health care: the UNIPLUS Program. To verify the scientific nature of the artifact and ensure that it meets the criteria set by the community and the environment, the premises of Design Science Research (DSR) were used. As this research field lacks empirical evidence, the artifact was tested from 2013 to 2015 with 25 health care service providers from different
more » ... ies, with an emphasis on hospitals and clinics located in 7 cities in the south of Brazil. This article makes 3 main contributions to the field: (1) the artifact can be applied to any health insurance operator in Brazil and other countries, as it meets the legal norms and requirements established by current legislation; (2) it helps health service providers by generating information that identifies shortfalls and possibilities for improvement for every aspect analyzed in the evaluation process; and (3) it uses the DSR methodology in an evaluation artifact that evaluates the quality and performance of services in the field of health care. The artifact proved to be adequate for the purpose in question, helping to improve the quality of care and institutional performance. Keywords design science research, quality assessment, health service providers, supplementary health, self-managed health insurance companies Original Research What do we already know about this topic? Methods of assessing the quality of health service delivery exist, but are not shared. How does your research contribute to the field? It presents a complete methodology that can be applied anywhere in the world by adjusting to local legislation. What are your research's implications toward theory, practice, or policy? It contributes in a theoretical way in the presentation of an artifact and of practical form in the applicability of this artifact.
doi:10.1177/0046958018790168 pmid:30156927 fatcat:svlsnfho7rfw3l2f46zbt47zj4