Page 13 - 2022-28-中国全科医学

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·世界全科医学工作瞭望·

2021—2022 年版英国质量与结果框架的设计

及其对我国的启示

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李雪竹，匡莉，张慧 * 查看原文

【摘要】 我国基层医疗卫生机构在承担基本公共卫生服务和基本医疗服务项目方面存在绩效考核体系和支付制
度不完善的问题。英国质量与结果框架（QOF）经过多次调整，最新版本更加注重慢性病防控与疾病管理质量。本研
究从管理与运作体系、指标体系的演变历程及新版（2021—2022 年版）指标构成、计分规则和按绩效付费规则等方面
对英国 QOF 进行介绍，并剖析了英国新版 QOF 的设计细节和运行情况。本研究发现，英国 QOF 是一个以结果为导向
的质量控制系统和以报酬为导向的激励机制，其以主要慢性病及其危险因素为管理重点，通过设置三级指标体系，并
规定指标分值和每分值对应的金额，实现将全科诊所服务质量与其绩效报酬相联系，能够从整体上提高英国卫生系统
的效能。借鉴 QOF 的经验，我国应完善基本公共卫生服务规范与绩效考核指标体系、基层门诊慢性病支付方式，促进
基本公共卫生服务资金和基本医疗保险基金的统筹使用。
【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
【中图分类号】 R 197.1 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0223
李雪竹，匡莉，张慧 . 2021—2022 年版英国质量与结果框架的设计及其对我国的启示［J］. 中国全科医学，
2022，25（28）：3466-3474.［www.chinagp.net］
LI X Z，KUANG L，ZHANG H. Design of the UK Quality and Outcomes Framework for 2021—2022 and its implications
for China［J］. Chinese General Practice，2022，25（28）：3466-3474.

Design of the UK Quality and Outcomes Framework for 2021—2022 and Its Implications for China LI Xuezhu，KUANG
Li，ZHANG Hui *
School of Public Health，Sun Yat-sen University，Guangzhou 510080，China
*
Corresponding author：ZHANG Hui，Associate professor，Doctoral supervisor；E-mail：zhanghui3@mail.sysu.edu.cn
【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

基金项目：国家自然科学基金资助项目（71704194）；美国中华医学基金会公开竞标项目（19-339）
510080 广东省广州市，中山大学公共卫生学院
*
通信作者：张慧，副教授，博士生导师；E-mail：zhanghui3@mail.sysu.edu.cn
本文数字出版日期：2022-08-11