Eggleton Kyle, Liaw Winston, Bazemore Andrew
The University of Auckland, Auckland, New Zealand
The Robert Graham Center, Washington, DC.
Ann Fam Med. 2017 May;15(3):255-257. doi: 10.1370/afm.2075.
As the United States enters a new era of value-based payment heavy in emphasis on primary care measurement, careful examination of selected measures and their potential impact on outcomes and vulnerable populations is essential. Applying a theoretical model of health care quality as a coding matrix, we used a directed content analysis approach to categorize individual Merit Based Incentive Payment System (MIPS) measures. We found that most MIPS measures related to aspects of clinical effectiveness, whereas few, if any, related to aspects of access, patient experience, or interpersonal care. These gaps suggest that MIPS may fail to measure the broader aspects of health care quality and even risk worsening existing disparities.
随着美国进入一个高度重视初级保健评估的基于价值支付的新时代，仔细审视选定的评估措施及其对结果和弱势群体的潜在影响至关重要。我们将医疗保健质量的理论模型作为编码矩阵，采用定向内容分析方法对基于绩效的激励支付系统（MIPS）的各项具体措施进行分类。我们发现，大多数MIPS措施与临床有效性方面相关，而与可及性、患者体验或人际关怀方面相关的措施即便有也很少。这些差距表明，MIPS可能无法衡量医疗保健质量的更广泛方面，甚至有可能加剧现有的差距。
