医生的经济激励与反馈：医疗补助管理式医疗中癌症筛查未能增加
Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care.
作者信息
Hillman A L, Ripley K, Goldfarb N, Nuamah I, Weiner J, Lusk E
机构信息
University of Pennsylvania, Philadelphia, USA.
出版信息
Am J Public Health. 1998 Nov;88(11):1699-701. doi: 10.2105/ajph.88.11.1699.
Abstract
OBJECTIVES
A randomized controlled trial evaluated the impact of feedback and financial incentives on physician compliance with cancer screening guidelines for women 50 years of age and older in a Medicaid health maintenance organization (HMO).
METHODS
Half of 52 primary care sites received the intervention, which included written feedback and a financial bonus. Mammography, breast exam, colorectal screening, and Pap testing compliance rates were evaluated.
RESULTS
From 1993 to 1995, screening rates doubled overall (from 24% to 50%), with no significant differences between intervention and control group sites.
CONCLUSIONS
Financial incentives and feedback did not improve physician compliance with cancer screening guidelines in a Medicaid HMO.
摘要
目的
一项随机对照试验评估了反馈和经济激励措施对医疗补助健康维护组织（HMO）中50岁及以上女性癌症筛查指南的医生依从性的影响。
方法
52个初级保健机构中有一半接受了干预，其中包括书面反馈和经济奖励。评估了乳房X光检查、乳房检查、结肠直肠癌筛查和巴氏试验的依从率。
结果
从1993年到1995年，总体筛查率翻了一番（从24%提高到50%），干预组和对照组机构之间没有显著差异。
结论
在医疗补助健康维护组织中，经济激励和反馈并未提高医生对癌症筛查指南的依从性。
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本文引用的文献
1
From the Centers for Disease Control and Prevention. Trends in cancer screening--United States, 1987 and 1992.
JAMA. 1996 Feb 14;275(6):428-9.
2
Cancer screening. Knowledge, recommendations, and practices of physicians.
Cancer. 1993 Feb 1;71(3):839-43. doi: 10.1002/1097-0142(19930201)71:3<839::aid-cncr2820710329>3.0.co;2-e.
3
Office-based interventions to improve delivery of cancer prevention services by primary care physicians.基于办公室的干预措施，以改善初级保健医生提供癌症预防服务的情况。
Cancer. 1993 Aug 1;72(3 Suppl):1100-12. doi: 10.1002/1097-0142(19930801)72:3+<1100::aid-cncr2820721327>3.0.co;2-n.
4
Has the use of cervical, breast, and colorectal cancer screening increased in the United States?在美国，宫颈癌、乳腺癌和结直肠癌筛查的使用率是否有所增加？
Am J Public Health. 1995 Jun;85(6):840-2. doi: 10.2105/ajph.85.6.840.
5
Improving physician performance through peer comparison feedback.通过同行比较反馈提高医生绩效。
Med Care. 1984 Jun;22(6):527-34. doi: 10.1097/00005650-198406000-00003.
6
Delayed feedback of physician performance versus immediate reminders to perform preventive care. Effects on physician compliance.医生绩效的延迟反馈与预防保健执行的即时提醒。对医生依从性的影响。
Med Care. 1986 Aug;24(8):659-66. doi: 10.1097/00005650-198608000-00001.
7
Financial incentives to physicians.
N Engl J Med. 1986 Jul 3;315(1):59-61. doi: 10.1056/NEJM198607033150111.
8
Financial incentives for physicians in HMOs. Is there a conflict of interest?健康维护组织（HMO）中针对医生的经济激励措施。是否存在利益冲突？
N Engl J Med. 1987 Dec 31;317(27):1743-8. doi: 10.1056/NEJM198712313172725.
9
Effect of medical records' checklists on implementation of periodic health measures.病历检查表对定期健康措施实施的影响。
Am J Med. 1987 Jul;83(1):129-36. doi: 10.1016/0002-9343(87)90507-9.
10
Breast cancer screening by mammography: utilization and associated factors.乳腺钼靶筛查乳腺癌：利用情况及相关因素。
Am J Public Health. 1989 Nov;79(11):1499-502. doi: 10.2105/ajph.79.11.1499.
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