Implementing pay-for-performance in Australian primary care: lessons from the United Kingdom and the United States

We identify key lessons learned from the international experience of pay-for-performance and use them to formulate questions for Australia to consider before such a scheme is introduced. Discussion of lessons learned is based on a narrative review of the literature. We examined international evidence on factors to consider when designing pay-for-performance schemes, and the impact of these schemes on primary care practitioner behaviour and on primary care funding. Pay-for-performance schemes evolve over time, and usually involve several complex interventions including accreditation, education, quality improvement programs, investment in information technology and data collection systems, professional support and regional structures. These are all necessary conditions for linking financial incentives to quality of care. There is a strong argument for changing the existing service incentive payments program and investing the resources into revised outcome payments that provide rewards for annual improvements in numbers of patients receiving completed cycles of care. If pay-for-performance is to be introduced in Australia, several key lessons should be learned from the experiences of other countries. Pay-for-performance should be used as part of a wider strategy for quality improvement; it should not be seen as a panacea. Pay-for-performance should be used to drive quality improvement, not simply to reward those who are already providing high-quality care.     

Consensus standards for the care of children and adolescents in Australian health services

The medical and psychosocial needs of children and adolescents differ from those of adults, and this should be reflected in the care they receive in all areas of a health service. Children and adolescents must be accommodated separately to adults to ensure that their unique needs are met and risks of harm are minimised. The Standards for the care of children and adolescents in health services have been developed by a working group of clinicians, health service providers and consumer advocates based on a combination of available research evidence, published best practice guidelines and multidisciplinary expert consensus. Stakeholder input was obtained through invitations to comment, and pilot testing of the Standards was conducted in six metropolitan, regional and rural hospitals. The Standards provide detailed recommendations in the areas of recognising rights; the provision of child-, adolescent- and family-friendly health service facilities; the availability of child- and adolescent-specific equipment; and the importance of appropriately trained staff. To facilitate implementation and allow ongoing performance monitoring, the Standards have been developed for use alongside the Australian Council on Healthcare Standards Evaluation and Quality Improvement Program. The Standards provide a vehicle to ensure patient safety and to facilitate the provision of high-quality care for children and adolescents in Australian health services.     

实施区域医疗卫生服务 提高设备利用率

江原医院在明确自己定位的前提下,积极开展区域卫生医疗服务,加强与周边医院和单位的联系,取长补短,友好合作,提高了医院资源的利用率,方便了群众。1 现状和发展方向 我院系国家核心医学重点实验室临床部,拥有优良的专业技术队伍和先进的诊疗设施。全院卫技人员160余名,高级卫技人员30余名。我院先进的诊疗设施包括东芝800MAX线诊断机,东芝300/EZ-CT,西门子SPECT,双能X线骨密度仪,菲利浦产乳腺钼靶X线机,彩色多普勒,全自动生化     

Impeding the supply of expertise in Australian health care: actions of the Australian and New Zealand College of Anaesthetists

Australia is an attractive workplace for overseas-trained specialist (OTS) anaesthetists. The path to recognition of the qualifications and experience of OTS anaesthetists is, in my opinion, bogged down in an overzealous assessment procedure. The Australian and New Zealand College of Anaesthetists (ANZCA) is a self-proclaimed professional body that is not subject to regulation by the federal government. Medical authorities such as the Australian Medical Council and state medical boards have no influence on ANZCA's assessment criteria and procedures. In my opinion, the current state of affairs with regard to assessment of OTS anaesthetists can not be justified.     

新医药卫生体制改革框架下药学服务型人才培养的探讨

2009年国家出台的新医药卫生体制改革方案中明确了药学服务的地位和作用,药学服务型人才的培养成为药学教育面临的重大和紧迫的任务.本文借鉴美国药学服务型人才培养的经验,结合我国实际情况,探讨了如何在办学理念、课程体系、教学内容、教学方法和师资队伍建设等方面进行改革和创新,构建药学服务型人才培养的新模式,为新医药卫生体制改革的实施提供人力保障.     

新医药卫生体制改革框架下药学服务型人才培养的探讨

2009年国家出台的新医药卫生体制改革方案中明确了药学服务的地位和作用,药学服务型人才的培养成为药学教育面临的重大和紧迫的任务.本文借鉴美国药学服务型人才培养的经验,结合我国实际情况,探讨了如何在办学理念、课程体系、教学内容、教学方法和师资队伍建设等方面进行改革和创新,构建药学服务型人才培养的新模式,为新医药卫生体制改革的实施提供人力保障.