The Ministry of Health of Kyrgyzstan within the framework of the “Health Results-Based Financing” (RBF) project supported by World Bank conducted the fifth review of colleagues to assess the quality of care provided in Hospitals. This review was conducted at the end of the third quarter of 2015. These reviews are conducted for the purpose of enhancing the quality of medical services in hospitals nationwide.
The selection procedure of hospitals, in which all 63 district and rural hospitals participated, including general practitioner’s centers, was held in the Ministry of Health of the Kyrgyz Republic in June 2014. Hospitals were divided into three groups: in the first group, quarterly assessment on the quality of medical services are conducted with payment based on results (‘Group 1’), in the second group - quarterly assessment of the quality of medical services are done without paying for results (‘Group 2’) and Hospitals in the third group do not receive any intervention.
Participants in the fifth review of the hospitals included the RBF Secretariat, experts of the Technical Team, staff of the quality evaluation departments of the Territorial offices of the Mandatory Health Insurance Fund (MHIF), and representatives of non-governmental health organizations.
According to the deputy director of the RBF project Mr. Narynbek Kudaibergenov, since the start of project implementation in July 2014 when a baseline review was held, five other reviews of the quality of medical services with the use of Balanced Scorecards (BSCs) were done. This BSC has a specific set of criteria and indicators. The assessment is made on a quarterly basis with the participation of colleagues from other hospitals in observer status. Hospitals in the first group are paid based on the results achieved; the higher their performance the higher their rewards. It is encouraging that there is a constant increase in performance.
Comparing results of the fifth review to the fourth review showed growth in the average total of scores from 627.3 (62.7%) to 686.9 points (68.7%), with an increase of 59 points. Kochkor territorial hospital scored the maximum points (949) or 95% score.
Also GPCs Chong Alai, Kara-Suu and Moscow territorial hospital work stable and systematically and demonstrate increased performance by increasing scores.
The increase in the average evaluation is 17 points on the Scorecard, from 546.1 to 563.4 points in the second group of hospitals. At the end of the fifth review the maximum score (894; 89.4%) in this group was scored by Nookat territorial hospital.
The lowest number of points (340) during the fifth review in the first group of hospitals was scored by Tash-Kumyr city territorial hospital while in the second group General Practitioners Center Malabasheva (186 points) scored lowest. These two health organizations throughout the reviews get low scores, they underperform in the main indicators in the categories of "management", "hygiene", "training", "quality assurance", and "children under 5 years."
“Of course the financing, based on results does not replace the total funding, and we are only talking about one part of the total financing, which will allow the hospital to develop and solve small problems” - said Chairman of MHIF under Government of KR Marat Kaliev who was participating in the fifth review. – “But in general, it should significantly change the performance and the results of these hospitals” he added. In addition, we are talking about increasing the capacity of their leaders. And, if they used to perform simple administrative functions coming from superior organizations, directives and orders, but now through the prism indicated in the Scorecard indicators, they analyze the situation in each unit of their hospitals, beginning from management and ending warehouses, pharmacies, sanitary units and etc., which allows you to watch and assess the situation at the system level, and every day to pay attention to these seemingly little things that ultimately provide effective results. "