IDMS QSAM - works really well for area sweeps. You can just turn it on and it will automatically do QSAM for the first area accessed by the run-unit. If your first DML statement is for a record in a different area, you will need to supply control cards, however, really easy to use.
IDMS Prefetch - if you are just doing area sweeps with no random access - use QSAM instead. For random access it takes some tinkering to get the prefetch done right. You may need to experiment with buffer sizes and when prefetch kicks in for the different areas. It is easy to unintentionally do prefetch for records that should be random access and you pay the price.
Large buffers - Buffers are done by specifying the buffer size for a file, and the buffer is expanded for all files within that buffer. There are limits, too large buffers and it appears performance will suffer when you do not get high enough a hit-rate. Large buffers can be used with some success in combination with QSAM and Prefetch.
Fast-Access - Easy to use and very good. In our testing we found that some workloads, such as unload/reload (most but not all) would be faster with QSAM. We also had workloads that had area sweeps with random access that were faster with Fats-Access than with any of the other methods listed above.
I found that about 2% of the jobs that used Fast-Access were negatively impacted by switching to IDMS QSAM, but I could not pin-point the reason for that impact - but it was between 20 and 40%. At your installation the percentage of jobs impacted will vary as well as how much that impact is, only proper testing will show the full picture.
I did not find any reason to use IDMS Prefetch, although there may be instances where that might perform better.
This post should not be regarded as a recommendation of Fast-Access, QSAM or Prefetch. Only testing at your site can identify what is best for your situation.