RAND Corporation, Santa Monica, CA, USA.
Health Aff (Millwood). 2010 May;29(5):926-32. doi: 10.1377/hlthaff.2009.0985.
Performance-based payments are increasingly common in primary care. With persistent disparities in the quality of care that different populations receive, however, such payments may steer new resources away from the care of racial and ethnic minorities and people of low socioeconomic status. We simulated performance-based payments to Massachusetts practices serving higher and lower shares of patients from these vulnerable communities in Massachusetts. Typical practices serving higher shares of vulnerable populations would receive less per practice compared to others, by estimated amounts of more than $7,000. These findings suggest that pay-for-performance programs should monitor and address the potential impact of performance-based payments on health care disparities.
基于绩效的支付在初级保健中越来越普遍。然而，由于不同人群所接受的医疗服务质量存在持续差异，这种支付方式可能会将新的资源从少数族裔和社会经济地位较低的人群的护理中转移走。我们对马萨诸塞州服务于高比例和低比例弱势群体患者的实践进行了基于绩效的支付模拟。与其他实践相比，服务于高比例弱势群体患者的典型实践每个实践收到的支付会更少，估计超过 7000 美元。这些发现表明，按绩效付费计划应监测和解决基于绩效的支付对医疗保健差异的潜在影响。
