Kelly J T, Feldman S E, Ross J E
Qual Assur Util Rev. 1987 Nov;2(4):107-10. doi: 10.1177/0885713x8700200403.
Several major, national forces have created the mandate of the Peer Review Organizations (PROs) for the evaluation of the quality of care received by Medicare patients. The shift of the Medicare Program to prospective payment to hospitals has caused concern that this change in financial incentives may have adverse effects on quality. An analysis and review of the experience of the California PRO (California Medical Review, Inc.)--including the application of sanctions--suggests that corrective actions have been successful in addressing quality deficiencies. However, the relationship between those deficiencies and the prospective payment mechanism remains unclear.
几支主要的全国性力量促成了同行评审组织（PROs）对医疗保险患者所接受医疗服务质量进行评估的使命。医疗保险计划向医院采用前瞻性付费的转变引发了人们的担忧，即这种财务激励措施的变化可能会对质量产生不利影响。对加利福尼亚州PRO（加利福尼亚医疗评审公司）经验的分析和审查——包括制裁措施的应用——表明纠正措施已成功解决了质量缺陷问题。然而，这些缺陷与前瞻性付费机制之间的关系仍不明确。
