Who to pay for performance? The choice of organisational level for hospital performance incentives
Who to pay for performance? The choice of organisational level for hospital performance incentives
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DOI：
10.1007/s10198-015-0690-0
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发表时间：
2016-05-01
影响因子：
4.4
通讯作者：
Lauridsen, Jorgen T.
中科院分区：
文献类型：
--
作者：
Kristensen, Soren Rud;Bech, Mickael;Lauridsen, Jorgen T.
改善医院护理质量的经济激励措施[称为绩效工资（P4P）]可以直接针对医院级别，也可以重新分配给科室级别。从理论上讲，分配给较低组织级别的绩效工资比直接分配给医院级别的绩效工资在提高绩效方面更有效，但这种预期的经验证据很少。本文比较了有和没有向科室层面重新分配绩效工资的医院科室的绩效。我们研究了丹麦的 P4P 计划，为患者提供个案经理。应用差异分析中的差异，我们估计接受直接财务激励的医院部门的绩效会提高 5 个百分点。我们的结果表明，付款人可以通过将付款分配到部门级别而不是医院级别来提高 P4P 付款的有效性。
Financial incentives for quality improvement in hospital care [known as pay for performance (P4P)] can be directed to either the hospital level or redistributed to the department level. Theoretically, performance payments distributed to lower organisational levels are more effective in increasing performance than payments directed to the hospital level, but the empirical evidence for this expectation is scarce. This paper compares the performance of hospital departments at hospitals that do and do not redistribute performance payments to the department level. We study a Danish P4P scheme to provide patients with case managers. Applying difference in differences analysis, we estimate a 5 percentage points higher performance at hospital departments that are subject to a direct financial incentive. Our results suggest that payers can improve the effectiveness of P4P payments by distributing payments to the department level rather than the hospital level.