与英国绩效支付相关的一般实践特征:系统性审查
Rhatica Srai1, David Cromwell1, Nicholas Mays1
1Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
英国一般实践中的质量和成果框架 (QOF) 绩效支付计划显示了实践特征和绩效之间的关联. 一些因素,如社会经济贫困和老年患者人群,与较低的QOF得分有关,引发了公平问题的担忧.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 一般实践管理的管理.
- 医疗保健政策分析 政策分析
背景情况:
- 质量和成果框架 (QOF) 是英国一般实践中的一个重要的绩效支付倡议,自2004年以来一直影响实践收入.
- 在一般实践中,人们对QOF对股权的影响存在担忧.
研究的目的:
- 在质量和成果框架 (QOF) 中确定与绩效相关的实践特征.
主要方法:
- 一项对研究的系统审查,研究英国一般实践特征与QOF绩效之间的关系.
- 搜索包括MEDLINE,Embase,CINAHL+,科学网站和灰色文学.
主要成果:
- 二十二项研究 (2006-2022) 对人口和组织特征进行了分析,与QOF措施相比.
- 在QOF表现和社会经济贫困,老年患者群体,较大的列表大小,较老的GP平均年龄和替代提供者医疗服务合同之间发现了负面关联.
- 团队实践,更高的全职同等 (FTE) 医师数量和培训实践与更好的QOF表现有关.
结论:
- 实践的特点,无论是可控制的还是不可控制的,都会影响QOF的性能.
- 按绩效支付的计划可能会使服务于高风险人群 (老年人,贫困者) 的实践处于不利地位.
- 需要使用最新数据进行进一步的研究,以确认和理解持久关系.
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