Volpp Kevin G, Pauly Mark V, Loewenstein George, Bangsberg David
Center for Health Incentives, Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, USA.
Health Aff (Millwood). 2009 Jan-Feb;28(1):206-14. doi: 10.1377/hlthaff.28.1.206.
Unhealthy behavior is a major cause of poor health outcomes and high health care costs. In this paper we describe an agenda for research to guide broader use of patient-targeted financial incentives, either in conjunction with provider-targeted financial incentives (pay-for-performance, or P4P) or in clinical contexts where provider-targeted approaches are unlikely to be effective. We discuss evidence of proven effectiveness and limitations of the existing evidence, reasons for underuse of these approaches, and options for achieving wider use. Patient-targeted incentives have great potential, and systematic testing will help determine how they can best be used to improve population health.
不健康行为是导致健康状况不佳和医疗成本高昂的主要原因。在本文中，我们描述了一项研究议程，以指导更广泛地使用针对患者的经济激励措施，这些措施可以与针对提供者的经济激励措施（绩效薪酬，即P4P）相结合，或者在针对提供者的方法不太可能有效的临床环境中使用。我们讨论了已证实的有效性证据和现有证据的局限性、这些方法未得到充分使用的原因，以及实现更广泛使用的选择。针对患者的激励措施具有巨大潜力，系统测试将有助于确定如何最好地利用它们来改善人群健康。
