Pimperl Alexander F, Rodriguez Hector P, Schmittdiel Julie A, Shortell Stephen M
1 University of California, Berkeley, CA, USA.
2 Kaiser Permanente Northern California, Oakland, CA, USA.
Med Care Res Rev. 2018 Oct;75(5):562-585. doi: 10.1177/1077558717696993. Epub 2017 Mar 8.
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that influence more robust PMSYS among physician organizations. Using a nationally representative survey of U.S. medical practices, we examined the extent to which organizational capabilities and external factors were associated with more developed PMSYS. Linear regression estimated the relative impact of these factors on PMSYS. On average, practices implemented a minority (32 points out of 100) of the PMSYS processes assessed. Practices evaluated ( p < .01) or financially incentivized by external entities ( p < .01), receiving data from health plans ( p < .01), participating in an accountable care organization ( p < .01), affiliating with an independent practice association and/or physician-hospital organization ( p < .01), and using health information technology ( p < .01) and chronic disease registries ( p < .01) to greater degrees had more robust PMSYS. PMSYS of medical practices are underdeveloped, although both external incentives and organizational capabilities may support PMSYS development.
绩效管理系统（PMSYS）有助于提高医疗质量和效率，但对于影响医师组织中更强大的PMSYS的因素却知之甚少。我们通过对美国医疗实践进行全国代表性调查，研究了组织能力和外部因素与更发达的PMSYS之间的关联程度。线性回归估计了这些因素对PMSYS的相对影响。平均而言，实践机构实施了所评估的PMSYS流程中的少数部分（满分100分中的32分）。受到外部实体评估（p <.01）或经济激励（p <.01）、从健康计划接收数据（p <.01）、参与 accountable care organization（p <.01）、隶属于独立执业协会和/或医师 - 医院组织（p <.01），以及更大程度地使用健康信息技术（p <.01）和慢性病登记系统（p <.01）的实践机构拥有更强大的PMSYS。医疗实践的PMSYS发展不足，尽管外部激励和组织能力都可能支持PMSYS的发展。
