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2009年9月21日 · This paper explains the reasons and context behind the introduction of the Quality and Outcomes Framework (QOF) in the UK in April 2004. The QOF is a pay-for-performance scheme covering a range of clinical and organisational areas in primary care. In 2004, 52% of the framework related to clinical care, increasing to 66% in 2006 and 70% in 2009.

本文以英国的质量与结果框架（qof）为典型案例，系统说明了英国按质量支付的内容、实施效果及未来走向，旨在为中国支付方式改革提供经验借鉴。

2004 年,英国国家健康体系(National Health Service, NHS)引入了世界上最大、健康相关、按绩效付费的绩效薪酬方案——质量与结果框架(QOF)1。 然而,目前苏格兰正在放弃该方案,英格兰对此渐渐醒悟,很可能会导致一些重大改变。 我们从中学到了什么,未来QOF会发生些什么? 在上世纪90 年代末,在英国,全科医师的工资已经大大落后于专科医师,全科医学的士气和招聘情况堪忧。 政府和英国医学会(British Medical Association, BMA)私下一致认为有必要大幅加薪。 资金的来源也没 …

When a QOF related contractual dispute arises, the commissioner and contractor would be expected to make every reasonable effort to communicate and co-operate with each other with a view to resolving the dispute without the need to refer it for formal determination by NHS Resolution (Primary Care Appeals) (or in certain cases, the courts).

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。

质量与结果框架（qof）加速了先前的广泛使用电子病历和多学科团队管理慢性疾病的趋势. qof结果导致了相对有限的额外质量改进，但减少了医疗照护中的社会经济不平等. 由于缺乏专业的支持或实施过程存在问题，一些指标被废除

The Quality and Outcomes Framework (QOF) is a system for the performance management and payment of general practitioners (GPs) in the National Health Service (NHS) in England, Wales, Scotland and Northern Ireland. It was introduced as part of a new general medical services (GMS) contract in April 2004, replacing various other fee arrangements.

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 …

2024年3月28日 · This document provides additional guidance on the interpretation and verification of the quality and outcomes (QOF) indicators for 2024/25 in England.