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WONCA研究論文摘要匯編——安大略省初級(jí)保健癌癥篩查成本激勵(lì)效應(yīng)

發(fā)布時(shí)間:2018-09-06 08:55
【摘要】:目的盡管績(jī)效薪酬已被廣泛應(yīng)用,但是能證明其有效性的證據(jù)卻少之又少。此研究評(píng)價(jià)了加拿大安大略省的初級(jí)護(hù)理醫(yī)師引入績(jī)效薪酬與癌癥檢出率提升的相關(guān)性,并且將確定醫(yī)師的薪酬作為此項(xiàng)研究的一部分。方法對(duì)管理數(shù)據(jù)進(jìn)行縱向分析,以確定1999—2000年到2009—2010年每一財(cái)政年度的癌癥檢出率和激勵(lì)成本。通過(guò)分段線性回歸分析,評(píng)價(jià)在2006—2007年引進(jìn)激勵(lì)后,癌癥檢出率的趨勢(shì)是否有變化或急劇變化。分析中納入了所有安大略省的宮頸癌、乳腺癌和結(jié)腸癌的檢查。結(jié)果研究發(fā)現(xiàn),引進(jìn)激勵(lì)后3種癌癥的檢出率并沒有發(fā)生較大變化。結(jié)腸癌檢出率在引進(jìn)激勵(lì)前每年的增長(zhǎng)速度為3.0%〔95%CI(2.3%,3.7%)〕,引進(jìn)激勵(lì)之后每年為4.7%〔95%CI(3.7%,5.7%)〕。引進(jìn)激勵(lì)后,宮頸癌和乳腺癌每年的檢出率未見較大變化。2006—2007年到2009—2010年,分別投入了2 830萬(wàn)、3 130萬(wàn)和5 000萬(wàn)美元用于宮頸癌、乳腺癌和結(jié)腸癌的財(cái)政激勵(lì)。結(jié)論盡管投入了大量財(cái)政成本,績(jī)效薪酬計(jì)劃幾乎未能改善檢出率。決策者應(yīng)考慮其他策略提升癌癥檢出率。
[Abstract]:Objective although performance pay has been widely used, there is little evidence to prove its effectiveness. The study evaluated the correlation between the introduction of performance pay by primary care physicians in Ontario, Canada, and increased cancer detection rates, and identified physician pay as part of the study. Methods the management data were analyzed longitudinally to determine the cancer detection rate and incentive cost for each fiscal year from 1999-2000 to 2009-2010. A piecewise linear regression analysis was used to evaluate whether the trend of cancer detection rate had changed or changed sharply after the introduction of incentives in 2006-2007. The analysis included all Ontario screening for cervical, breast and colon cancer. Results the results showed that there was no significant change in the detection rate of three kinds of cancer after the introduction of stimulation. The detection rate of colon cancer increased by 3.0% per year before the introduction of stimulation (95%CI (2.37%) after the introduction of), was 4.7% (95%CI (3.7%). Since the introduction of incentives, the detection rate of cervical cancer and breast cancer has not changed significantly. From 2006-2007 to 2009-2010, $28.3 million and $50 million were spent on financial incentives for cervical cancer, breast cancer and colon cancer, respectively. Conclusion despite the large financial cost, performance pay plan can hardly improve the detection rate. Decision makers should consider other strategies to increase cancer detection rates.
【作者單位】: 中國(guó)石油天然氣集團(tuán)公司中心醫(yī)院;
【分類號(hào)】:R730.4
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本文編號(hào):2225843

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