Murphy Karen M, Nash David B
Physicians Health Alliance, Clarks Summit, Pennsylvania 18411, USA.
Am J Med Qual. 2008 Nov-Dec;23(6):427-39. doi: 10.1177/1062860608324557.
The current pay-for-performance movement in health care has continued to evolve despite the absence of input from physicians and empirical evidence of its effectiveness. The majority of existing quality incentive programs related to physician services is limited to primary care physicians. There is an increasing movement among payers to broaden pay for performance to include nonprimary care physicians. This article reports the results of a survey of nonprimary care physicians' views on office-based quality incentive and improvement programs. Data were collected from surveys completed by nonprimary care physicians practicing cardiology, hematology, oncology, obstetrics and gynecology, orthopedic surgery, and urology. Findings indicate that nonprimary care physicians recognize some value in office-based quality incentive and improvement programs. Specialty societies played a significant role in influencing physicians' views on office-based quality improvements. Physicians indicated support for incentive designs that included infrastructure grants to implement improvements in their office such as an electronic medical record.
尽管缺乏医生的参与以及其有效性的实证证据,但当前医疗保健领域的按绩效付费运动仍在不断发展。现有的与医生服务相关的大多数质量激励计划仅限于初级保健医生。支付方越来越倾向于将按绩效付费扩大到非初级保健医生。本文报告了一项关于非初级保健医生对基于办公室的质量激励和改进计划看法的调查结果。数据收集自从事心脏病学、血液学、肿瘤学、妇产科、整形外科和泌尿外科的非初级保健医生所完成的调查问卷。调查结果表明,非初级保健医生认识到基于办公室的质量激励和改进计划具有一定价值。专业协会在影响医生对基于办公室的质量改进的看法方面发挥了重要作用。医生们表示支持包括基础设施拨款在内的激励设计,以便在其办公室实施改进措施,如电子病历。