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从澳大利亚视角看口腔健康服务的按人头付费和按服务收费支付模式的系统文献综述

Systematic Literature Review of Capitation and Fee-for-Service Payment Models for Oral Health Services: An Australian Perspective.

作者信息

Conquest Jennifer H, Gill Nirjgot, Sivanujan Praveena, Skinner John, Kruger Estie, Tennant Marc

机构信息

School of Human Sciences, University of Western Australia, Perth 6009, Australia.

Dentistry, James Cook University, Cairns 4870, Australia.

出版信息

Healthcare (Basel). 2021 Aug 30;9(9):1129. doi: 10.3390/healthcare9091129.

Abstract

The aim of this review was to assess relevant global literature on capped-fee (CF) and fee-for-service (FFS) payment models as used by public dental services. Research data were assessed through the PRISMA check list and sourced from MEDLINE, PubMed, ProQuest, Cochrane Library, and other methods. The inclusion criteria were peer reviewed articles published between 2004 and 2020 and (i) other countries' health systems that were evaluated in contrast to Australia; (ii) care provided to individuals; (iii) payment models for private services that were the same as Australian government policy (CF and FFS); and (iv) care provided by dentists. We used a mixed methodology for data collection. A total of 262 references were reviewed with 10 references meeting the inclusion criteria with the quality rating being: three-strong, six-moderate, and one-weak. The literature included studies from Sweden (three references), Ireland (three references), United Kingdom (six references), United States of America (two references), and Norway (one reference). Four references included studies within multiple countries. The sample size varied between 20 and 106,874 participants. The two payment systems can impact on individual outcomes, such as by overtreatment in an FFS system and undertreatment in a CF system.

摘要

本综述的目的是评估公共牙科服务所采用的封顶费用(CF)和按服务收费(FFS)支付模式的相关全球文献。研究数据通过PRISMA清单进行评估,并来源于MEDLINE、PubMed、ProQuest、Cochrane图书馆及其他途径。纳入标准为2004年至2020年间发表的同行评议文章,以及(i)与澳大利亚相比进行评估的其他国家卫生系统;(ii)提供给个人的护理;(iii)与澳大利亚政府政策相同的私人服务支付模式(CF和FFS);(iv)牙医提供的护理。我们采用混合方法进行数据收集。共审查了262篇参考文献,其中10篇参考文献符合纳入标准,质量评级为:三篇强、六篇中等和一篇弱。文献包括来自瑞典(三篇参考文献)、爱尔兰(三篇参考文献)、英国(六篇参考文献)、美国(两篇参考文献)和挪威(一篇参考文献)的研究。四篇参考文献包括多个国家的研究。样本量在20至106,874名参与者之间。这两种支付系统会对个体结果产生影响,例如在FFS系统中可能出现过度治疗,而在CF系统中可能出现治疗不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aedd/8469501/b672a350a838/healthcare-09-01129-g001.jpg

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