Voinea-Griffin Andreea, Rindal D Brad, Fellows Jeffrey L, Barasch Andrei, Gilbert Gregg H, Safford Monika M
Department of General Dental Sciences, University of Alabama at Birmingham, AL, USA.
J Healthc Qual. 2010 Jan-Feb;32(1):51-8. doi: 10.1111/j.1945-1474.2009.00064.x.
Little is known about the effect of a pay-for-performance system (P4P) on primary medical care providers and even less is known about its potential impact in dentistry. Based on the growing acceptance of performance-based reimbursements in medicine and the dissemination of innovative technologies, structures, and processes of care from medical to dental services, it is likely that the dental profession will face performance-based payments in the not-too-distant future. In this paper, we present the current experience of P4P in primary medical care that has relevance to dentistry and discuss the dental performance-based programs to date. Taking into consideration these lessons, the structure of dental service delivery in the United States, and the paucity of evidence-based quality indicators in dentistry, we provide several guidelines for the design of P4P pilot programs for dental services. We conclude that large-scale implementation of P4P for dentistry may not be a realistic option before significant progress is achieved in quality of dental care indicators.
关于绩效薪酬制度（P4P）对初级医疗服务提供者的影响，人们了解甚少，而对于其在牙科领域的潜在影响，所知更少。基于医学领域对基于绩效的报销方式的接受度不断提高，以及创新技术、护理结构和流程从医疗服务向牙科服务的传播，牙科行业很可能在不久的将来面临基于绩效的支付方式。在本文中，我们介绍了P4P在与牙科相关的初级医疗服务中的当前经验，并讨论了迄今为止基于牙科绩效的项目。考虑到这些经验教训、美国牙科服务的提供结构以及牙科领域基于证据的质量指标的匮乏，我们为牙科服务P4P试点项目的设计提供了几条指导方针。我们得出结论，在牙科护理指标质量取得重大进展之前，大规模实施牙科P4P可能不是一个现实的选择。
