Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers
Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers
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你能得到你付出的代价吗？
DOI：
10.2139/ssrn.1381463
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
M. Rosenthal
中科院分区：
文献类型：
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作者：
Kathleen J. Mullen;R. Frank;M. Rosenthal
尽管绩效工资(P4P)作为一种提高医疗质量的工具在卫生政策制定者和私营保险公司中很受欢迎，但其有效性几乎没有经验基础。我们使用发表的与大型网络HMO签约的医生医疗小组的业绩报告中的数据，相对于对照组，比较实施P4P之前和之后的临床质量。我们考虑了P4P对质量的奖赏和不奖赏两个维度的影响。最后，我们没有找到证据表明，大规模的P4P倡议要么导致了质量的重大改善，要么显著地扰乱了医疗保健。
Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness. We use data from published performance reports of physician medical groups contracting with a large network HMO to compare clinical quality before and after the implementation of P4P, relative to a control group. We consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, we fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.