Hazelwood Anita, Cook Ellen D
College of Sciences, University of Louisiana at Lafayette, LA 70504, USA.
Health Care Manag (Frederick). 2008 Apr-Jun;27(2):104-12. doi: 10.1097/01.HCM.0000285037.12043.a3.
The issue of quality of care is not new to the US health care system. Providers have been required to participate in quality improvement activities by governmental and accrediting agencies for quite some time. The public, too, is becoming increasingly involved in evaluating the quality of care provided in facilities from which they seek care. Transparency in pricing and quality of care is of critical interest to patients, health plans, and employers. On August 22, 2006, President George W. Bush signed an executive order supporting the promotion of efficient and quality health care to US citizens in health care programs administered and sponsored by the federal government, such as Medicare, Medicaid, and Tricare.However, the idea of tying reimbursement to these quality standards is growing and becoming a significant element of the health care field. Value-based purchasing refers to the many ways that health care purchasers are attempting to measure, monitor, and improve the quality of care that is received for money spent. Pay for performance is one of the emerging programs in this area. The expectation of pay for performance is that patient outcomes will be improved by rewarding providers based on predetermined measures.
医疗质量问题在美国医疗体系中并非新鲜事。一段时间以来，政府和认证机构一直要求医疗服务提供者参与质量改进活动。公众也越来越多地参与评估他们寻求医疗服务的机构所提供的医疗质量。价格和医疗质量的透明度是患者、健康计划和雇主极为关注的问题。2006年8月22日，乔治·W·布什总统签署了一项行政命令，支持在由联邦政府管理和资助的医疗保健项目（如医疗保险、医疗补助和军人医疗保健计划）中，向美国公民推广高效和优质的医疗保健。然而，将报销与这些质量标准挂钩的想法正在不断发展，并成为医疗保健领域的一个重要因素。基于价值的采购是指医疗保健购买者试图衡量、监测和提高所花钱财换来的医疗服务质量的多种方式。按绩效付费是该领域新兴的项目之一。按绩效付费的期望是，通过根据预先确定的指标奖励医疗服务提供者来改善患者的治疗结果。
