INCENTIVES AND PROVIDER PAYMENT METHODS
INCENTIVES AND PROVIDER PAYMENT METHODS
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DOI：
10.1002/hpm.4740100104
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发表时间：
1995-01-01
影响因子：
2.7
通讯作者：
SAXENIAN, H
中科院分区：
文献类型：
--
作者：
BARNUM, H;KUTZIN, J;SAXENIAN, H
这种支付方式产生了强有力的激励，影响到提供者的行为以及卫生筹资改革的效率、公平和质量成果。 本文探讨了供应商的激励措施以及行政成本，并成功实施与供应商支付替代方案的制度条件。 所考虑的替代办法是预算改革、按人头收费、按服务收费和按个案报销。 我们的结论是，无论是通过受监管的私营部门还是公共系统内的竞争，都有可能提高任何支付方式的性能。 所有的方法都会产生不利和有利的刺激。 混合形式的供应商支付系统可以提供权衡，以抵消个别模式的缺点。 低收入国家应避免需要更高水平的体制发展的复杂支付系统。
The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.