英国QOF的做法、经验与启示

Discussing the Implementation,Experiences and Enlightenment from QOF in Britain.

随着基于绩效的支付(Pay for performance:P4P)在全球盛行,英国于2004年发起质量和结果框架(Qualityand Outcome Frame:QOF)项目,作为全球最大型的P4P项目之一,在英国全科医疗领域实施。英国的卫生行政部门、许多国家级权威学术机构、社会组织等参与了实施方案与评估工具的制定和项目的执行。QOF项目强调自愿参与,但英国大多数全科医生参与其中,并根据其绩效从初级保健信托(Primary Care Trust:PCT)获得补偿。通过分析英国QOF项目的做法,对我国在社区卫生服务机构实施绩效考核的启示是:应采取多种措施确保考核工具的权威性和科学性;绩效考核应当制度化,以确保其落实到位;重视绩效考核者的资质和考核过程中的沟通与反馈;完善信息系统和健全立法,以支持绩效考核的实施。

With the pervasiveness of Pay for performance（P4P） in the world,Program of Quality and Outcome Frame（QOF） was launched in England in 2004,and implemented in general practice.As it is one of the biggest P4P programs,health administration,many prestigious national academic institutes and social organizations participated in formulating the scheme and evaluation tool,and implementing performance evaluation.QOF is a voluntary program,but most GPs had participated in it and were compensated on the basis of their performance from Primary Care Trust（PCT）.Enlightenment from QOF on implementing performance evaluation for CHS institutions in China are as follows： taking comprehensive measures to ensure authoritative and scientific performance evaluation tool,systematizing performance evaluation to put it into practice,emphasizing the qualifications of performance appraisers and communications and feedback in the course of evaluation,and improving information and legislations system to support performance evaluation.