Goldman L Elizabeth, Henderson Stuart, Dohan Daniel P, Talavera Jason A, Dudley R Adams
Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, CA 94143, USA.
Inquiry. 2007 Summer;44(2):137-45. doi: 10.5034/inquiryjrnl_44.2.137.
Safety-net hospitals (SNHs) may gain little financial benefit from the rapidly spreading adoption of public reporting and pay-for-performance, but may feel compelled to participate (and bear the costs of data collection) to meet public expectations of transparency and accountability. To better understand the concerns that SNH administrators have regarding public reporting and pay-for-performance, we interviewed 37 executives at randomly selected California SNHs. The main concerns noted by SNH executives were that human and financial resource constraints made it difficult for SNHs to accurately measure their performance. Additionally, some executives felt that market-driven public reporting and pay-for-performance may focus on clinical areas and incentive structures that may not be high-priority clinical areas for SNHs. Executives at SNHs suggested several policy responses to these concerns-such as offering training programs for SNH data collectors-that could be relatively inexpensive and might improve the cost-benefit ratio of public reporting and pay-for-performance programs.
安全网医院（SNHs）可能无法从迅速普及的公开报告和按绩效付费中获得多少经济利益，但可能会觉得有必要参与（并承担数据收集成本），以满足公众对透明度和问责制的期望。为了更好地理解SNH管理人员对公开报告和按绩效付费的担忧，我们采访了随机挑选的加利福尼亚州SNHs的37位高管。SNH高管指出的主要担忧是，人力和财力资源的限制使SNHs难以准确衡量其绩效。此外，一些高管认为，市场驱动的公开报告和按绩效付费可能侧重于临床领域和激励结构，而这些领域可能并非SNHs的高优先级临床领域。SNHs的高管针对这些担忧提出了几项政策应对措施，比如为SNH数据收集者提供培训项目，这些措施可能成本相对较低，并且可能提高公开报告和按绩效付费项目的成本效益比。
