Gelfand Erwin W, Colice Gene L, Fromer Leonard, Bunn William B, Davies Thomas J
Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA.
Ann Allergy Asthma Immunol. 2006 Sep;97(3):298-305. doi: 10.1016/S1081-1206(10)60793-4.
To discuss the Health Plan Employer Data and Information Set (HEDIS) criteria for measuring performance in asthma care and to review new strategies to improve the quality of asthma care.
Expert opinion from a roundtable on National Committee for Quality Assurance HEDIS and asthma care, supplemented with a MEDLINE database search to identify articles published between January 1, 1990, and May 31, 2005, with the following keywords in the title: asthma plus HEDIS, pay for performance, incentive programs, reimbursement, or employee education.
Studies and review articles were selected for their relevance to measuring the quality of asthma care using HEDIS and improving care using newer trends, such as employee education and physician incentive programs.
Components of the HEDIS asthma measure have been found to correlate with outcomes, including risk of hospitalization and emergency department visits. However, refinements to the measure may be needed because it may misclassify a portion of patients as having persistent asthma who actually have intermittent asthma according to National Heart, Lung, and Blood Institute criteria. Physician incentive programs are increasingly being explored as a means of improving the quality of care while managing costs. Under current pay-for-performance programs, rewards are issued to providers who demonstrate high-quality care based on the HEDIS asthma measure.
The HEDIS asthma measure remains the most widely used performance tool for evaluating the quality of asthma care. Reimbursement models based on public reporting and pay for performance are expected to be a strong component of future health care payment systems.
探讨用于衡量哮喘护理绩效的健康计划雇主数据与信息集（HEDIS）标准，并回顾提高哮喘护理质量的新策略。
来自全国质量保证委员会HEDIS与哮喘护理圆桌会议的专家意见，并辅以MEDLINE数据库检索，以识别1990年1月1日至2005年5月31日期间发表的文章，文章标题中包含以下关键词：哮喘加HEDIS、按绩效付费、激励计划、报销或员工教育。
选择与使用HEDIS衡量哮喘护理质量以及利用员工教育和医生激励计划等新趋势改善护理相关的研究和综述文章。
已发现HEDIS哮喘指标的组成部分与包括住院风险和急诊就诊在内的结果相关。然而，可能需要对该指标进行完善，因为根据美国国立心肺血液研究所的标准，它可能会将一部分实际上患有间歇性哮喘的患者误分类为持续性哮喘患者。越来越多地探索医生激励计划，作为在控制成本的同时提高护理质量的一种手段。在当前的按绩效付费计划下，会向基于HEDIS哮喘指标提供高质量护理的提供者发放奖励。
HEDIS哮喘指标仍然是评估哮喘护理质量最广泛使用的绩效工具。基于公开报告和按绩效付费的报销模式预计将成为未来医疗保健支付系统的重要组成部分。
