选择退出质量和成果框架 (QOF) 以及对实践绩效的影响
V Tzortziou Brown1, J Hayre1, J Ford1
1Wolfson Institute of Population Health, Queen Mary University of London, UK.
Public health in practice (Oxford, England)
|July 23, 2024
概括
选择退出英国的质量和成果框架 (QOF) 财政激励措施导致了与QOF相关的护理质量指标略有下降. 替代整体护理激励计划受到一般实践的积极欢迎.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 卫生经济学 卫生经济学
背景情况:
- 在一般实践中,越来越多地使用财政激励来提高护理标准.
- 这些激励措施,特别是英国一般实践中的质量和成果框架 (QOF) 对实际护理质量的影响仍然不清楚.
- 本研究探讨了选择退出QOF计划的一般做法所带来的后果.
研究的目的:
- 评估选择退出质量和成果框架 (QOF) 金融激励计划的一般做法的影响.
- 将选择退出QOF的实践与继续参与的实践的表现进行比较.
- 评估一种替代性的,在当地设计的,促进整体护理的金融激励计划的影响.
主要方法:
- 采用了回顾性前后研究设计,分析了伦敦东部塔哈姆雷茨所有实践机构的数据.
- 实践者可以选择不接受QOF而不受经济处罚,而是采用当地设计的激励计划.
- 采用了2016/17年和2017/18年国家公开可用的QOF成就数据,对16个特定的QOF指标进行了分分析.
主要成果:
- 在36个实践中,有29个选择退出QOF. 选择退出实践的实践显示,QOF总成绩得分的小但统计学上显著下降.
- 对16个QOF指标的分分析显示,选择退出实践的成就得分在统计学上显著下降,特别是当排除例外时.
- 当考虑QOF例外率时,选择退出和继续实践之间的绩效差异减少了.
结论:
- 停止QOF金融激励措施可能会导致QOF相关指标的实现减少,其规模受到例外率的影响.
- 专注于更全面的患者护理方法的替代激励计划似乎受到一般实践的好评.
- 这些发现表明,金融激励,绩效指标和在初级保健中采用替代护理模式之间存在微妙的关系.
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