“医院基于价值购买”支付项目的特点及借鉴
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摘要
总结了"医院基于价值购买"项目的发展历史和特点,分析了其对我国推进按绩效付费制度的借鉴意义。"医院基于价值购买"项目是美国在其原有按绩效付费制度基础上发展而来、针对联邦医疗保险的支付项目。自推行以来,该项目已获得初步成功,成功引导其所覆盖的医院关注并进行了相应的品质改进活动。国内按绩效付费制度的发展仍处在初级阶段,在建立、推行相关制度时可借鉴"医院基于价值购买"项目的特点,促进医院间价值层面的竞争,制定方向清晰的指标体系,动态调整指标以引导持续改进。
This article summarized the development and features of Hospital Value-Based Purchasing, and analyzed the implications for China promoting pay-for-performance program. HVBP was developed from the U.S. original payfor-performance program, and was based on Medicare payment. Since its first introduction in 2013, HVBP has achieved an initial success, and guided the hospitals covered to focus on the quality-improving activities related to the program.The Development of pay-for-performance is still in an early stage in China. Therefore, when establishing similar system China can learn from HVBP in the following aspects: promoting competition in values between hospitals, setting simple measures to create a clear direction, and adjusting measures dynamically to promote continuous improving.
This article summarized the development and features of Hospital Value-Based Purchasing, and analyzed the implications for China promoting pay-for-performance program. HVBP was developed from the U.S. original payfor-performance program, and was based on Medicare payment. Since its first introduction in 2013, HVBP has achieved an initial success, and guided the hospitals covered to focus on the quality-improving activities related to the program.The Development of pay-for-performance is still in an early stage in China. Therefore, when establishing similar system China can learn from HVBP in the following aspects: promoting competition in values between hospitals, setting simple measures to create a clear direction, and adjusting measures dynamically to promote continuous improving.
引文
[1]Cromwell J,Trisolini M,Pope G,et al.Pay for performance in health care:methods and approaches[J].Jama the Journal of the American Medical Association,2011,308(24):2626-2637.
[2]Centers for Medicare and Medicaid Services.What are the value-based programs?[EB/OL].(2018-07-25)[2018-11-24].https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/Value-Based-Programs/ValueBased-Programs.html.
[3]Tompkins CP,Higgins AR,Ritter GA.Measuring outcomes and efficiency in medicare value-based purchasing[J].Health Affairs,2009,28(2):251-261.
[4]Schroeder SD.Hospital valuebased purchasing[J].Journal of Hospital Medicine,2013,8(5):271-277.
[5]Lemeneh T,James P,Goodrich K.Medicare’s hospital value-based purchasing program[J].Health Affairs,2015,34(6):1070-1079.
[6]吴荣海,向前.“医院基于价值购买”对我国支付制度改革的借鉴与思考[J].中国卫生经济,2017,36(6):42-44.
[7]Centers for Medicare and Medicaid Services.Hospital value-based purchasing(HVBP)measures[EB/OL].(2017-10-31)[2018-11-25].https://www.qualitynet.org/dcs/ContentServer?c=Page&pagena me=QnetPublic%2FPage%2FQnetTier3&c id=1228773784227.
[8]Janus P.Messy but fair:the ACA’s hospital value-based purchasing program and the notice-and-comment process[J].Journal of Legal Medicine,2017,37(4):325-369.
[9]Ryan AM,Krinsky S,Maurer KA,et al.Changes in hospital quality associated with hospital value-based purchasing[J].New England Journal of Medicine,2017,376(24):2358-2366.
[10]Germán M,Pardini CA.Association between medicare’s mandatory hospital value-based purchasing program and cost inefficiency[J].Applied Health Economics&Health Policy,2017,16(4):1-12.
[11]张力,蒲川,成秋娴,等.英美按绩效付费对我国社区卫生服务机构绩效考核的启示[J].中国全科医学,2016,19(25):3019-3022.
[12]贾洪波,王清河.医疗保障按绩效付费运行方式探究[J].价格理论与实践,2016(5):35-39.
[2]Centers for Medicare and Medicaid Services.What are the value-based programs?[EB/OL].(2018-07-25)[2018-11-24].https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/Value-Based-Programs/ValueBased-Programs.html.
[3]Tompkins CP,Higgins AR,Ritter GA.Measuring outcomes and efficiency in medicare value-based purchasing[J].Health Affairs,2009,28(2):251-261.
[4]Schroeder SD.Hospital valuebased purchasing[J].Journal of Hospital Medicine,2013,8(5):271-277.
[5]Lemeneh T,James P,Goodrich K.Medicare’s hospital value-based purchasing program[J].Health Affairs,2015,34(6):1070-1079.
[6]吴荣海,向前.“医院基于价值购买”对我国支付制度改革的借鉴与思考[J].中国卫生经济,2017,36(6):42-44.
[7]Centers for Medicare and Medicaid Services.Hospital value-based purchasing(HVBP)measures[EB/OL].(2017-10-31)[2018-11-25].https://www.qualitynet.org/dcs/ContentServer?c=Page&pagena me=QnetPublic%2FPage%2FQnetTier3&c id=1228773784227.
[8]Janus P.Messy but fair:the ACA’s hospital value-based purchasing program and the notice-and-comment process[J].Journal of Legal Medicine,2017,37(4):325-369.
[9]Ryan AM,Krinsky S,Maurer KA,et al.Changes in hospital quality associated with hospital value-based purchasing[J].New England Journal of Medicine,2017,376(24):2358-2366.
[10]Germán M,Pardini CA.Association between medicare’s mandatory hospital value-based purchasing program and cost inefficiency[J].Applied Health Economics&Health Policy,2017,16(4):1-12.
[11]张力,蒲川,成秋娴,等.英美按绩效付费对我国社区卫生服务机构绩效考核的启示[J].中国全科医学,2016,19(25):3019-3022.
[12]贾洪波,王清河.医疗保障按绩效付费运行方式探究[J].价格理论与实践,2016(5):35-39.