Effects of Pay for Performance on the Quality of Primary Care in England
Effects of Pay for Performance on the Quality of Primary Care in England
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DOI：
10.1056/nejmsa0807651
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发表时间：
2009-07-23
影响因子：
158.5
通讯作者：
Roland, Martin
中科院分区：
文献类型：
--
作者：
Campbell, Stephen M.;Reeves, David;Roland, Martin
背景 2004年，英格兰的家庭诊所引入了基于达到临床护理质量目标的按绩效付费计划。方法我们对42个代表性家庭诊所的护理质量进行了间断时间序列分析，数据在该计划实施前的两个时间点（1998年和2003年）和实施后的两个时间点（2005年和2007年）收集。在每个时间点，从病历中提取有关哮喘、糖尿病或冠心病患者护理的数据；通过问卷收集患者对获得护理的机会、护理的连续性以及护理的人际方面的看法的数据。分析包括与激励措施相关和无关的护理方面。 结果 2003 年至 2005 年间，哮喘和糖尿病的护理质量改善率有所增加（P
BackgroundA pay-for-performance scheme based on meeting targets for the quality of clinical care was introduced to family practice in England in 2004.MethodsWe conducted an interrupted time-series analysis of the quality of care in 42 representative family practices, with data collected at two time points before implementation of the scheme (1998 and 2003) and at two time points after implementation (2005 and 2007). At each time point, data on the care of patients with asthma, diabetes, or coronary heart disease were extracted from medical records; data on patients' perceptions of access to care, continuity of care, and interpersonal aspects of care were collected from questionnaires. The analysis included aspects of care that were and those that were not associated with incentives.ResultsBetween 2003 and 2005, the rate of improvement in the quality of care increased for asthma and diabetes (P