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関連する概念動画

Persuasion Strategies01:52

Persuasion Strategies

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Researchers have tested many persuasion strategies, including the foot-in-the door and the door-in-the-face techniques, in a variety of contexts. Ultimately, the principles are effective in selling products and changing people’s attitude, ideas, and behaviors (Cialdini & Goldstein, 2004).
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Social Facilitation01:04

Social Facilitation

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Not all intergroup interactions lead to negative outcomes. Sometimes, being in a group situation can improve performance. Social facilitation occurs when an individual performs better when an audience is watching than when the individual performs the behavior alone. This typically occurs when people are performing a task for which they are skilled.
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Compensation Mechanisms01:28

Compensation Mechanisms

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The human body employs intricate mechanisms to counteract changes in blood pH, preventing conditions like acidosis (pH < 7.35) and alkalosis (pH > 7.45). These compensatory responses aim to restore normal arterial blood pH by engaging respiratory or renal systems, depending on the source of the imbalance.
Respiratory Compensation
This mechanism addresses metabolic-induced pH imbalances by adjusting breathing rates. Respiratory compensation begins within minutes of detecting a pH...
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Steps in the Modeling Process01:14

Steps in the Modeling Process

874
Albert Bandura's theory of observational learning identifies four critical processes: attention, retention, motor reproduction, and reinforcement or motivation.
Attention is the first necessary component for observational learning. It involves focusing on what the model is doing and saying. For example, if you decide to take a drawing class to enhance your skills, you need to pay close attention to the instructor's words and hand movements. The characteristics of the model significantly...
874
First Derivative Test: Problem Solving01:25

First Derivative Test: Problem Solving

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Imagine an asset price that crashes to a low point, rebounds sharply as bargain-hunters step in, and then gradually declines. Such behavior can be modeled with a smooth function whose turning points represent locally overvalued and undervalued regions. A convenient example that captures rebound followed by decay is:The high and low points of this curve are identified using the first derivative test, which determines where the function changes from increasing to decreasing or vice versa. To...
227
Sources of Self-Esteem II: Performance Feedback01:24

Sources of Self-Esteem II: Performance Feedback

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Self-esteem is intricately tied to our perception of competence and our ability to exert control over our lives. One of the primary sources of this perception is performance feedback — the ongoing evaluation of our actions in terms of success and failure. According to Franks and Marolla (1976), people derive self-worth from experiencing themselves as causal agents, capable of achieving goals and overcoming obstacles. This process nurtures a critical component of self-esteem:...
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Movement Retraining using Real-time Feedback of Performance
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パフォーマンスの報酬に関する初期の経験: 概念から実践へ

Meredith B Rosenthal1, Richard G Frank, Zhonghe Li

  • 1Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass 02115, USA. meredith_rosenthal@harvard.edu

JAMA
|October 13, 2005
PubMed
まとめ
この要約は機械生成です。

パフォーマンスの報酬型プログラムでは,医療の質の向上は限られている. プログラムは多くの場合,より高いパフォーマンスを発揮する医師に報酬を与え,潜在的に品質の向上への投資に対してほとんど価値を提供しません.

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関連する実験動画

Last Updated: May 5, 2026

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科学分野:

  • 医療サービス 研究 医療サービス
  • 医療の質の向上 医療の質の向上
  • 健康経済学 医療経済学

背景:

  • パイ・フォー・パフォーマンス (PFP) の採用は増加していますが,医療におけるその有効性に関する研究はほとんどありません.
  • 楽観的な見方にもかかわらず,PFPの臨床品質への影響に関する経験的証拠は依然として限られている.

研究 の 目的:

  • 医者のPFPプログラムが患者のケア品質に与える影響を評価する.
  • PFPイニシアチブが特定の臨床プロセスの施策に与える影響を評価する.

主な方法:

  • カリフォルニアの医師グループ (介入) と太平洋北西部のグループ (比較) を比較した自然実験の設計.
  • 約300の医師団の2001年10月から2004年4月までの行政品質報告書の分析.
  • 3つの重要なプロセス対策に焦点を当てた: 子宮頸がんスクリーニング,マンモグラフィー,およびヘモグロビンA1c検査.

主要な成果:

  • カリフォルニアは,太平洋北西部と比較して子宮頸がんのスクリーニング (5.3%対1.7%) でより大きな改善を示し,統計的に有意な違いを示しました.
  • マンモグラフィーとヘモグロビンA1c検査は,グループ間の品質改善の違いが最小であることを示した.
  • 医療従事者のグループでは,すでにパフォーマンスの値を満たしている医師が,最低の改善を示したにもかかわらず,ボーナスの支払いの最大の割合を受け取った.

結論:

  • 固定された PFP 目標は,プログラムコストに比べて質の改善を最小限に抑えることができます.
  • PFPプログラムは,主にベースラインでのパフォーマンスの高い臨床医に報酬を与え,潜在的に品質の向上のための投資収益を制限します.