对绩效的报酬是否会影响社会经济上的不平等? 来自英国医院专科护理的证据
Alberto Núñez-Elvira1, Yan Feng2, Søren Rud Kristensen3
1Institute of Global Health Innovation, Imperial College London, London, United Kingdom.
Health policy (Amsterdam, Netherlands)
|July 15, 2025
概括
在英格兰,为表现付费.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 绩效支付 (PFP) 计划旨在提高医疗保健的质量和效率.
- 人们担心PFP可能会加剧医疗保健获取现有的社会经济不平等.
- 本研究研究了PFP对英国专科医院护理中的社会经济差异的影响.
研究的目的:
- 调查英格兰专门医院护理的PFP如何影响患者获得医疗服务的社会经济不平等.
- 评估PFP计划对不同社会经济地位的患者的影响.
主要方法:
- 利用来自医院病例统计 (2012/132016/17) 的患者级管理数据.
- 采用差异差异模型来分析PFP计划的影响.
- 采用PFP的医院 (治疗组) 和不采用PFP的医院 (对照组) 之间的结果比较.
主要成果:
- 对于创伤护理,PFP扩大了社会经济不平等,更少的贫困患者减少了出院延迟.
- 创伤护理PFP在最不需要的五分位数中减少了2.4个小时的延迟,而在最需要的五分位数中则减少了1.3个小时.
- 对于紧急冠状动脉旁路手术患者,没有观察到显著的社会经济差异.
结论:
- 在英格兰,PFP在特殊创伤护理中加剧了社会经济上的不平等.
- 紧急冠状动脉旁路手术的PFP似乎没有造成或加剧社会经济差异.
- 调查结果强调,需要仔细设计PFP计划,以减轻对健康公平的潜在负面影响.
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