November - 2012
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Reduced Mortality with Hospital Pay for Performance in EnglandMatt Sutton, Silviya Nikolova, Ruth Boaden, Helen Lester, Ruth McDonald and Martin Roland N Engl J Med, 2012, 2012; 367:1821-1828 This page is only available to Crit-IQ subscribers. To view the rest of this review and gain access to our vast array of critical care teaching tools including podcasts, vodcasts, modules, exam preparation tools, teaching aids and much more, login here, or Become a Member to register |
November |
Previous Comments
| So they spend an extra 4.8million pounds, and save 890 lives (only in the pneumonia or combined endpoint - all other endpoints were no different, despite them reporting non-significant differences...) And all of this during 2009... I also couldn't find in the paper whether the mortality benefit only occurred in the hospitals that received extra funding via bonuses, or whether any of the benefit was experienced by the 50% of hospitals that received no extra funding. This is not evidence that competition is helpful - this just demonstrates that increased funding may improve outcomes... | |
| franno-13 Nov, 2012 01:26:49 AM | |
| Certainly the results seem equivocal, as you say only 1 of 3 conditions improved, and there were improvements in mortality in non pay for performance hospitals as well. For me there is an alternate question this raises - How do you improve outcomes for sepsis related diseases, like pneumonia, that can be difficult to recognise, involve a number of teams, and may benefit from timely application of "best-practice" | |
| Neilo-13 Nov, 2012 05:45:31 PM | |
Comment
Pay-for-performance programs are increasingly being implemented in hospital systems. The evidence to date has been scant, with evidence to date suggesting know effect on mortality or clear benefit to patient outcomes. This UK study reports on "Advancing Quality", a program...