《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]
卷:
第25卷
期数:
2018年02期
页码:
128-130
栏目:
视窗2018
出版日期:
2018-03-28
- 作者:
-
杨巧 陈登菊 张伟 符美玲 肖明朝
-
重庆医科大学附属第一医院
- 关键词:
-
美国医保; 英国医保; 按绩效支付
- Keywords:
-
Health Insurance; US; UK; Pay for Performance
- DOI:
-
10.13912/j.cnki.chqm.2018.25.2.39
- 摘要:
-
文章围绕绩效评价内容、评价指标、评价结果运用等内容，介绍了美国的医院质量激励示范项目和以价值为基础的报销项目，以及英国的按质量与结果付费机制、质量和创新服务计划。研究发现，美英等国医保按绩效支付方式具有医疗质量与医保支付有机结合，横向评价与纵向评价相结合，奖与惩相结合，评估工具动态调整等特点。启示我国应转变观念，将医保支付与医疗质量评价相结合，设置科学、公平、客观的评价指标，建立有效的激励机制，以提高医保基金使用率和医疗服务质量水平。
- Abstract:
-
Focusing on the evaluation content, evaluation index, evaluation result application of the pay for performance (PFP), the study introduced the hospital quality demonstration project and the value-based reimbursement program in US, and the payment system according to the quality and result, quality and innovation service plan in UK. The PFP in countries such as the US and UK has the characteristics of organic integration of medical quality and health insurance payment, combining vertical and horizontal evaluation, integration of award and punish, the dynamic adjustment of the assessment tools, etc. The enlightenment to China includes change of ideas, combining medical insurance payment and medical quality evaluation, establishment of scientific, fair and objective evaluation index, establishment of effective incentive mechanism, in order to improve the medical insurance fund utilization rate and the level of medical service quality.
更新日期/Last Update:
2018-03-28
