Quimbo Stella A, Peabody John W, Shimkhada Riti, Woo Kimberly, Solon Orville
University of the Philippines, Economics, Quezon City, Philippines.
Soc Sci Med. 2008 Aug;67(4):505-10. doi: 10.1016/j.socscimed.2008.04.013. Epub 2008 Jun 4.
It is unclear whether health provider accreditation ensures or promotes quality of care. Using baseline data from the Quality Improvement Demonstration Study (QIDS) in the Philippines we measured the quality of pediatric care provided by private and public doctors working at the district hospital level in the country's central region. We found that national level accreditation by a national insurance program influences quality of care. However, our data also show that insurance payments have a similar, strong impact on quality of care. These results suggest that accreditation alone may not be sufficient to promote high quality of care. Further improvements may be achieved with properly monitored and well-designed payment or incentive schemes.
尚不清楚医疗服务提供者的认证是否能确保或提升医疗质量。利用菲律宾质量改进示范研究（QIDS）的基线数据，我们衡量了该国中部地区区级医院的私立和公立医生所提供的儿科护理质量。我们发现，国家保险计划的国家级认证会影响医疗质量。然而，我们的数据还表明，保险支付对医疗质量也有类似的强烈影响。这些结果表明，仅靠认证可能不足以促进高质量的医疗服务。通过适当监督和精心设计的支付或激励计划，可能会取得进一步的改进。
