英国专业服务的绩效支付激励措施:一种混合方法评估
Yan Feng1, Søren Rud Kristensen2,3, Paula Lorgelly4,5
1Centre for Evaluation and Methods, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, Whitechapel, London, E1 2AB, UK. yan.feng@qmul.ac.uk.
规定的专业服务委托质量和创新 (PSS CQUIN) 计划在改善专业医疗保健服务方面取得了有限的成功. 从这一绩效支付计划中吸取的经验教训可以为未来的医疗保健激励设计提供信息.
科学领域:
- 医疗保健管理的管理
- 医疗服务研究 医疗服务研究
- 质量改善举措 质量改善举措
背景情况:
- 英格兰NHS在2013/2014年为罕见和复杂的疾病引入了规定的专业服务委托质量和创新 (PSS CQUIN).
- 本研究评估了从2016/2017年到2018/2019年的PSS CQUIN合同实施情况.
研究的目的:
- 评估PSS CQUIN计划对目标结果的有效性.
- 探索在专业医疗保健服务中设计合同和实施方案的复杂性.
主要方法:
- 一种混合方法方法,结合了定量 (差异差异与倾向得分匹配) 和定性 (半结构面试,焦点小组) 分析.
- 量化分析评估了对目标结果和成本的影响.
- 定性分析使用常量比较方法探索了实施挑战.
主要成果:
- PSS CQUIN计划对目标结果的影响有限,只有一个计划显示了统计学上显著的改善 (成年重症监护人员在创伤中及时出院的7%的增加).
- 影响有限的潜在原因包括小型激励支付,复杂的计划设计以及所有权,合同和灵活性等问题.
- 没有观察到对专业服务整体质量改善的重大影响.
结论:
- PSS CQUIN计划对提高专业医疗服务质量的影响很小,甚至没有任何影响.
- 未来的绩效支付计划应考虑该研究的研究结果,以提高激励设计和实施战略的效率.
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