Berkeley Center forHealth Technology, University of California, Berkeley, CA, USA.
Health Aff (Millwood). 2009 Sep-Oct;28(5):1438-47. doi: 10.1377/hlthaff.28.5.1438.
Pay-for-performance (P4P) programs are expanding their purview from quality to include efficiency, and many consider the episode of care as the appropriate unit of measurement. Two years' experience by the California P4P program, however, reveals that the requisite claims data often are incomplete or poorly coded and that even large physician groups have too few patients experiencing most types of episodes to permit statistically valid measurement for public reporting and incentive payment. The California P4P program is shifting its efficiency focus to metrics not reliant on episode measurement while shifting episode measurement to supporting bundled payment for acute surgical and medical interventions.
按绩效付费（P4P）计划正在将其范围从质量扩展到包括效率，许多人认为护理期是合适的测量单位。然而，加利福尼亚州 P4P 计划两年的经验表明，所需的索赔数据通常不完整或编码不良，即使是大型医生团体，也只有少数患者经历大多数类型的护理期，无法进行有效的统计测量，以进行公共报告和激励性支付。加利福尼亚州 P4P 计划正在将其效率重点转移到不依赖于护理期测量的指标上，同时将护理期测量转移到支持急性外科和医疗干预的捆绑支付上。
