关键词: 质量与结果框架, 按绩效付费, 基本公共卫生服务, 基本医疗服务, 国家卫生服务，英国

Abstract:

In China, the performance appraisal system measuring the performance in delivering essential public health services and medical services, and the patient payment system for these services in primary health institutions are still imperfect. The UK Quality and Outcomes Framework (QOF) has been modified many times, and the latest version (2021—2022) places more emphasis on chronic disease prevention and control and the quality of disease management. We introduced the UK QOF, involving its management and operation system, modification process of the indicators, and the indicator composition, scoring rules and performance management of its latest version, particularly detailed the design and operation of its latest version, and summarized the following insights: the UK QOF is a result-oriented quality control system and a reward-oriented incentive mechanism, which focuses on the management of major chronic diseases and their risk factors. Through the establishment of a three-level management system for each major disease, with defined scores and corresponding payment for the indicators, the general practices obtain the payment according to their service quality, thereby increasing the efficiency of the healthcare system in the UK as a whole. The design and operation of the UK QOF will contribute to the improvement of China's national essential public health service specifications and performance assessment systems as well as payment methods for chronic disease outpatient management services in primary care, which in turn boosts the appropriate allocation of the fund for essential public health services and the basic medical insurance fund generally.

Key words: Quality and Outcomes Framework, Pay for performance, Essential public health services, Essential medical services, National Health Service, British