一般实践激励措施:国际文献的综述
Mark Harris1, Joel Rhee2, Margo Barr3
1University of New South Wales, International Centre for Future Health Systems, Sydney, Australia.
在一般实践中,混合支付模式显示出改善护理质量的潜力,特别是在复杂的慢性疾病中. 然而,针对特定激励措施的证据,如绩效支付,是可变的,需要仔细评估.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 澳大利亚的一般实践面临着当前服务费 (FFS) 模式的挑战.
- 重新评估初级保健资金对于质量结果至关重要.
研究的目的:
- 系统地审查一般实践融资模式的证据.
- 评估复杂慢性疾病的质量结果的疗效.
- 确定影响实施的上下文因素.
主要方法:
- 对评论和元分析的系统审查.
- 搜索了主要的数据库 (PubMed,Cochrane等) 从2010年开始.
- 遵循PRISMA系统审查指南.
主要成果:
- 混合支付模式 (用资本或FFS支付绩效) 显示了小的质量改善.
- 益处在多学科环境和糖尿病护理中最明显.
- 对其他疾病的证据是不确定的;仅仅从Capitation没有改善.
结论:
- 混合支付模式看起来很有前途,但效率是可变的.
- 仔细评估激励措施对质量和公平性的影响至关重要.
- 需要进一步研究复杂慢性护理的最佳资金.
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