title: Application of the analytic hierarchy process in the performance measurement of colorectal cancer care for the design of a pay-for-performance program in Taiwan.
abstract: OBJECTIVE
  To prioritize performance measures for colorectal cancer care to facilitate the implementation of a pay-for-performance (PFP) system.
  
  
  METHODS
  Questionnaires survey.
  
  
  METHODS
  Medical hospitals in Taiwan.
  
  
  METHODS
  Sixty-six medical doctors from 5 November 2009 to 10 December 2009.
  
  
  METHODS
  Analytic hierarchy process (AHP) technique. Main outcome measure(s) Performance measures (two pre-treatment, six treatment related and three monitoring related) were used.
  
  
  RESULTS
  Forty-eight doctors responded and returned questionnaires (response rate 72.7%) with surgeons and physicians contributing equally. The most important measure was the proportion of colorectal patients who had pre-operative examinations that included chest X-ray and abdominal ultrasound, computed tomography or MRI (global priority: 0.144), followed by the proportion of stages I-III colorectal cancer patients who had undergone a wide surgical resection documented as 'negative margin' (global priority: 0.133) and the proportion of colorectal cancer patients who had undergone surgery with a pathology report that included information on tumor size and node differentiation (global priority: 0.116). Most participants considered that the best interval for the renewal indicators was 3-5 years (43.75%) followed by 5-10 years (27.08%).
  
  
  CONCLUSIONS
  To design a PFP program, the AHP method is a useful technique to prioritize performance measures, especially in a highly specialized domain such as colorectal cancer care.
authors.affiliation: Graduate Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Kuo-Piao
authors.initials: KP
authors.lastname: Chung
authors.forename: Li-Ju
authors.initials: LJ
authors.lastname: Chen
authors.forename: Yao-Jen
authors.initials: YJ
authors.lastname: Chang
authors.forename: Yun-Jau
authors.initials: YJ
authors.lastname: Chang
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lai
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D019990:Perioperative Care / Q000592:standards; D010865:Pilot Projects; D019984:Quality Indicators, Health Care / Q000145:classification*; D012052:Reimbursement, Incentive; D011795:Surveys and Questionnaires; D013624:Taiwan