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

To prioritize performance measures for colorectal cancer care to facilitate the implementation of a pay-for-performance (PFP) system. Questionnaires survey. Medical hospitals in Taiwan. Sixty-six medical doctors from 5 November 2009 to 10 December 2009. Analytic hierarchy process (AHP) technique. Performance measures (two pre-treatment, six treatment related and three monitoring related) were used. 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 IIII colorectal cancer patients who had undergone a wide surgical resection documented as onegative 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 35 years (43.75) followed by 510 years (27.08). 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.