University of Wisconsin-Madison, Department of Economics, Follette School of Public Affairs, Madison, WI 53706, USA.
Prev Chronic Dis. 2010 Sep;7(5):A94. Epub 2010 Aug 15.
Improving population health is not simple. Many instruments are available for changing behavior and consequent outcomes. However, the following basic principles should guide development of any incentive arrangement: 1) identify the desired outcome, 2) identify the behavior change that will lead to this outcome, 3) determine the potential effectiveness of the incentive in achieving the behavior change, 4) link a financial incentive directly to this outcome or behavior, 5) identify the possible adverse effects of the incentive, and 6) evaluate and report changes in the behavior or outcome in response to the incentive. A wide range of financial and nonfinancial incentives is available to encourage efficient behaviors and discourage costly and unproductive ones. Evidence for the beneficial effects of incentive programs has been slow to emerge, partly because such evidence must show how behaviors have changed because of the incentive. Nevertheless, the potential for incentive programs in health care seems large, and research should support their design and assess their effect.
提高人口健康水平并非易事。有许多工具可用于改变行为和相应的结果。然而，以下基本原则应指导任何激励安排的制定：1）确定期望的结果，2）确定将导致此结果的行为改变，3）确定激励在实现行为改变方面的潜在有效性，4）将财务激励直接与结果或行为联系起来，5）确定激励的可能不利影响，6）评估并报告激励措施对行为或结果的变化。有广泛的财务和非财务激励措施可用于鼓励高效行为，遏制代价高昂和无成效的行为。激励计划有益效果的证据迟迟未出现，部分原因是此类证据必须表明激励措施如何导致行为发生了变化。尽管如此，激励计划在医疗保健中的潜力似乎很大，研究应该支持其设计并评估其效果。
