Frølich Anne, Talavera Jason A, Broadhead Peter, Dudley R Adams
Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Health Policy. 2007 Jan;80(1):179-93. doi: 10.1016/j.healthpol.2006.03.001. Epub 2006 Apr 19.
The use of pay for performance (P4P) and public reporting of performance (PR) in health care is increasing rapidly worldwide. The rationale for P4P and PR comes from experience in other industries and from theories about incentive use from psychology, economics, and organizational behavior. This paper reviews the major themes from this prior research and considers how they might be applied to health care. The resulting conceptual model addresses the dual nature (combining direct financial and reputational incentives) of the initiatives many policymakers are pursuing. It also includes explicit recognition of the key contextual factors (at the levels of the markets and the provider organization) and provider and patient characteristics that can enhance or mitigate response to incentives. Evaluation of the existing literature (through June 2005) about incentive use in health care in light of the conceptual model highlights important weaknesses in the way that trials have been reported to date and suggests future research topics.
医疗保健领域中绩效薪酬（P4P）及绩效公开报告（PR）的应用在全球范围内正迅速增加。P4P和PR的理论依据源自其他行业的经验以及心理学、经济学和组织行为学中关于激励措施运用的理论。本文回顾了先前这项研究的主要主题，并探讨了如何将这些主题应用于医疗保健领域。由此得出的概念模型阐述了许多政策制定者所推行举措的双重性质（结合直接经济激励和声誉激励）。它还明确承认了关键的背景因素（在市场和医疗机构层面）以及可能增强或削弱对激励措施反应的提供者和患者特征。根据该概念模型对截至2005年6月有关医疗保健领域激励措施应用的现有文献进行评估，凸显了迄今试验报告方式存在的重要缺陷，并提出了未来的研究课题。
