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Sistemas de pago para mejorar la calidad, eficiencia y coordinación de la atención a los pacientes crónicos. Un marco y ejemplos nacionales.

Busse R, Blümel M
Papeles de Economía Española; 142: 50-61.




Payment Systems to Improve Quality, Efficiency, and Care Coordination for Chronically Ill Patients – A Framework and Country Examples: This paper focuses on new payment mechanisms in six countries and examines to what degree they include incentives for providers to improve coordination and/or quality of care. To (primarily) incentivize care coordination, countries give providers shared responsibility for their profits as they bundle payments. On the other hand, incentivizing (primarily) quality of care usually rewards one provider (GP or the hospital) who/which is responsible for delivering high-quality outcomes. Although promising approaches exist both for paying for care coordination and for paying for quality, countries do not currently aim at achieving both objectives at the same time. Thus, there is a need to develop payment mechanisms that incentivize both quality and care coordination. 




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