LA BASE DOCUMENTAIRE DE L'ORS AUVERGNE-RHÔNE-ALPES

Performance-based reimbursement in health care.

Titre traduit : Remboursement des soins médicaux basé sur la performance.
Auteurs physiques : FORSBERG (E.), AXELSSON (R.), ARNETZ (B.)
Titre du périodique : EUROPEAN JOURNAL OF PUBLIC HEALTH
Volume, numéro : 12
Numéro du fascicule : 1
Année d'édition : 2002/03
Pagination : 44-50
Résumé : The key question addressed in this study is whether performance-based reimbursement (PBR) is a useful way to create the right incentive for efficiency improvements in health care. In this 4-year prospective cohort study, physicians in one council with PBR and in ten councils without such a system were studied. The results of this study indicate that PBR, compared to an annual budget system, creates a different incentive, an'inner incentive'which may be stronger than the external incentive of financial pressures. PBR may result in a greater cost awareness and shorter average length of stay, but it may also lead to negative effects on the quality of care. A strong cost awareness was found to be a negative predictor of quality of care indicating that it is a difficult balancing act to maintain cost considerations at a'good'level in order to retain the benefits of cost awareness without adversely impacting quality of care. There is a need for further studies of the impact of PBR on financial performance and quality of care issues.
Mots-clés : Remboursement, Soins médicaux, Performance, Médecin, Condition travail, Bien être, Coût santé, Planification sanitaire, Hôpital, Tarification hospitalière, Tarification santé, Rémunération, Pratique médicale, Décision médicale, Efficience, Aide décision, Suède
Localisation : ORSRA : CREDES, réseau BDSP