基于绩效的融资:同中有异。

Performance-based financing: the same is different.

作者信息

Renmans Dimitri, Holvoet Nathalie, Criel Bart, Meessen Bruno

机构信息

Institute of Development Policy and Management, University of Antwerp, Lange Sint-Annastraat 7, 2000 Antwerp, Belgium.

Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.

出版信息

Health Policy Plan. 2017 Jul 1;32(6):860-868. doi: 10.1093/heapol/czx030.

Abstract

Although it is increasingly acknowledged within the Performance-Based Financing (PBF) research community that PBF is more than just payments based on outputs verified for quality, this narrow definition of PBF is still very present in many studies and evaluations. This leads to missed opportunities, misunderstandings and an unhelpful debate. Therefore, we reinforce the claim that PBF should be viewed as a reform package focused on targeted services with many different aspects that go beyond the health worker level. Failing to acknowledge the importance of the different elements of PBF negatively influences the task of practitioners, researchers and policymakers alike. After making the case for this wider definition, we propose three research pathways (describing, understanding and framing PBF) and give a short and tentative starting point for future research, leaving the floor open for more in-depth discussions. From these three vantage points it appears that when it comes to PBF 'the same is different'. Notwithstanding the increased complexity due to the use of the wider definition, progress on these three different research pathways will strongly improve our knowledge, lead to better adapted PBF programs and create a more nuanced debate on PBF.

摘要

尽管基于绩效的融资(PBF)研究界越来越认识到,PBF不仅仅是基于经质量验证的产出进行支付,但这种对PBF的狭义定义在许多研究和评估中仍然很常见。这导致了错失机会、误解以及无益的争论。因此,我们强调,PBF应被视为一个改革方案,其关注的是具有许多不同方面的针对性服务,这些方面超出了卫生工作者层面。未能认识到PBF不同要素的重要性会对从业者、研究人员和政策制定者的工作产生负面影响。在阐述了这一更宽泛定义的理由之后,我们提出了三条研究路径(描述、理解和构建PBF),并为未来研究给出了一个简短且初步的起点,以便展开更深入的讨论。从这三个有利视角来看,似乎在PBF方面“相同却又不同”。尽管使用更宽泛的定义会增加复杂性,但在这三条不同研究路径上取得的进展将极大地增进我们的知识,促成更适配的PBF项目,并引发关于PBF更细致入微的讨论。

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