Glied S
Division of Health Policy and Management, Columbia School of Public Health, New York, NY 10032, USA.
Health Serv Res. 1998 Oct;33(4 Pt 2):1143-60.
One way to improve the functioning of the American child healthcare system is through the design of incentives. Objective: to examine what we know and need to know about designing incentives to encourage the production of high-quality care both for healthy children and for children with serious illnesses.
For healthy children, incentives should encourage the provision of preventive services, including services that encourage healthy behavior. For children with serious illnesses, incentives should reduce risk selection, promote collaborative systems of care, and ensure access to appropriate specialty services. Research findings needed for incentive design includes information on the actual working of existing incentive mechanisms as well as information about risk adjustment, mixed payment system, carve-outs, and other mechanisms to reduce risk selection; options for defining service scope that encourage collaboration; and information about the ways in which quality measurement interacts with payment incentives.
改善美国儿童医疗保健系统运作的一种方法是通过激励措施的设计。目标：研究我们对于设计激励措施以鼓励为健康儿童和重症儿童提供高质量护理所了解及需要了解的内容。
对于健康儿童，激励措施应鼓励提供预防性服务，包括鼓励健康行为的服务。对于重症儿童，激励措施应减少风险选择，促进协作式护理系统，并确保获得适当的专科服务。激励措施设计所需的研究结果包括有关现有激励机制实际运作的信息，以及有关风险调整、混合支付系统、分割、以及其他减少风险选择机制的信息；定义鼓励协作的服务范围的选项；以及有关质量衡量与支付激励措施相互作用方式的信息。
