The RAND Corporation, Arlington, VA, USA.
Med Care Res Rev. 2010 Oct;67(5):574-89. doi: 10.1177/1077558709354522. Epub 2010 Jan 6.
With increasing attention paid to reducing racial/ethnic disparities in care and the growth of pay-for-performance programs, policy makers and payers are considering the use of such incentive mechanisms to target disparities reduction. This article describes the results of qualitative interviews with hospital executives to assess the potential impact that such programs would have on hospitals and their minority patients. The authors find that executives have significant concerns regarding funding mechanisms and implementation costs, financial risks for safety net hospitals, and resource constraints, as well as how such programs can be used to create incentives to care for minority patients. The findings suggest that payers should be hesitant to use pay-for-performance as a mechanism for reducing disparities until a wide variety of concerns about the design of such programs can be addressed.
随着人们越来越关注减少医疗服务中的种族/民族差异，以及绩效付费计划的增长，政策制定者和支付方正在考虑使用这种激励机制来针对减少差异。本文描述了对医院高管的定性访谈结果，以评估此类计划对医院及其少数族裔患者可能产生的影响。作者发现，高管们对资金机制和实施成本、对安全网医院的财务风险以及资源限制，以及这些计划如何用于激励为少数族裔患者提供护理等问题存在重大关切。研究结果表明，支付方在考虑使用绩效付费作为减少差异的机制之前，应该对这类计划的设计问题持谨慎态度，直到能够解决各种各样的担忧。
