改善初级保健查的财政干预:系统审查
Samantha Matthews1, Nabeel Qureshi1, Jonathan S Levin2
1RAND Corporation, Santa Monica, California.
American journal of preventive medicine
|March 14, 2024
概括
财政激励,特别是对关键绩效指标 (KPIs) 的支付,可以提高初级保健中的健康查率. 当实践者和提供者都收到这些付款时,这种证据最强烈.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 卫生经济学 卫生经济学
背景情况:
- 健康查的低采用率限制了早期发现和干预.
- 金融干预措施被探索为一种改善初级保健中查普及的策略.
研究的目的:
- 系统地审查旨在提高初级保健机构健康查率的财政干预措施.
- 确定有效的金融机制,以激励健康查.
主要方法:
- 对同行评审研究的系统审查 (2000-2023年).
- 按干预水平 (实践/个人) 和类型 (APM,FFS,资本,资本投资) 分类.
- 评估结果:查频率,护理质量和工作流程变化.
主要成果:
- 包括51项研究;大多数专注于实践级别的替代支付模式 (APM) 与关键绩效指标 (KPI) 支付.
- 向实践和提供者支付的KPI与查率的增加有关.
- 资本化和提供者级别的服务费用 (FFS) 模型显示出混合的结果;证据强度一般较低.
结论:
- 金融机制,特别是KPI支付,有效地提高了选率.
- 需要进一步研究金融干预对护理质量,临床过程和患者结果的影响.
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