Sikka Rishi
Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, USA.
Ann Emerg Med. 2007 Jun;49(6):756-61. doi: 10.1016/j.annemergmed.2006.06.032. Epub 2006 Sep 15.
One of the latest market-based solutions to the rising costs and quality gaps in health care is pay for performance. Pay for performance is the use of financial incentives to promote the delivery of designated standards of care. Pay for performance represents a dramatic change in the reimbursement of providers, from fixed rates or fees, to variable compensation based on the quality of care. This article serves as an introduction to pay for performance. I discuss the goals and structure of pay for performance plans and their limitations and potential consequences in the health care arena. A particular focus is provided on pay-for-performance initiatives affecting the emergency department either directly by contracting at the group level or indirectly through hospital reward programs. I also provide a strategy to guide constructive engagement by emergency physicians in the pay-for-performance movement.
针对医疗保健领域成本不断上升和质量差距问题，最新出现的基于市场的解决方案之一是按绩效付费。按绩效付费是指利用经济激励措施来推动达到指定的护理标准。按绩效付费意味着医疗服务提供者的报销方式发生了巨大变化，从固定费率或费用，转变为基于护理质量的可变薪酬。本文旨在介绍按绩效付费。我将讨论按绩效付费计划的目标、结构及其在医疗保健领域的局限性和潜在后果。特别关注通过集团层面签约直接影响急诊科的按绩效付费举措，以及通过医院奖励计划间接影响急诊科的举措。我还提供了一项策略，以指导急诊医生积极参与按绩效付费行动。
