对社区验证的结果与行动框架:津巴布韦基于绩效的融资计划的案例研究
Trina Gorman1,2, Bernardo Hernandez3,4, Geoff Garnett5
1Department of Global Health, University of Washington, Seattle, Washington, United States of America.
PLOS global public health
|August 26, 2025
概括
基于绩效的融资 (PBF) 验证仅使用设施记录可能导致过度支付和错误报告结果. 在PBF计划中,社区验证对于准确的服务交付验证至关重要.
科学领域:
- 健康经济学
- 公共卫生项目评价
- 卫生系统研究
背景情况:
- 基于绩效的融资 (PBF) 激励医疗服务提供者根据所取得的成果.
- 报告的服务数据的验证对于PBF的完整性至关重要.
- 目前的PBF验证通常严重依赖于设施记录 (数量验证),可能会忽视服务有效性.
研究的目的:
- 通过机构记录和患者采访,评估报告的自愿医疗男性割礼 (VMMC) 的可验证程度.
- 在PBF计划中确定设施级量验证和社区验证之间的对齐.
- 探索PBF报告的VMMC数据中的差异和潜在的数据伪造.
主要方法:
- 一种混合方法验证方法,结合数量验证 (设施记录) 和社区验证 (患者采访).
- 从DHIS2分析了36877名VMMC,以确定记录的完整性,并采访了2010名患者以确定数据的可信性.
- 两个验证方法的设施级绩效得分之间的相关性分析.
主要成果:
- 94%的VMMC设施记录是足够完整的.
- 只有55%的选定患者接受了采访,17%提供了不合理的数据.
- 在设施层面,数量验证和社区验证绩效得分之间没有发现相关性.
- 验证人员怀疑数据伪造和患者提供虚假的联系信息.
结论:
- 单单数量验证是PBF程序中服务交付准确性的不足代表.
- 仅依靠设施记录可能导致过度支付和不准确的业绩报告.
- 整合和加强社区验证方法对于PBF计划的问责制和有效性至关重要.
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