Wagner School of Public Service and the School of Medicine, New York University, New York City, USA.
Health Aff (Millwood). 2011 Jun;30(6):1165-75. doi: 10.1377/hlthaff.2010.1022.
In 2006 Massachusetts took the novel approach of using pay-for-performance--a payment mechanism typically used to improve the quality of care--to specifically target racial and ethnic disparities in hospital care for Medicaid patients. We describe the challenges of implementing such an ambitious effort in a short time frame, with limited resources. The early years of the program have yielded little evidence of racial or ethnic disparity in hospital care in Massachusetts, and raise questions about whether pay-for-performance as it is now practiced is a suitable tool for addressing disparities in hospital care.
2006 年，马萨诸塞州采取了新颖的方法，即采用按绩效付费（一种通常用于提高护理质量的支付机制），专门针对医疗补助患者的医院护理中存在的种族和民族差异。我们描述了在有限资源的情况下，在短时间内实施如此雄心勃勃的努力所面临的挑战。该计划的早期几乎没有证据表明马萨诸塞州的医院护理存在种族或民族差异，并对按绩效付费是否是解决医院护理差异的合适工具提出了质疑。
