Financial incentives for hospitals only reduce patient death rates in the short-term

August 06, 2014

Pay-for-performance schemes - which reward hospitals financially for improving the quality of care provided to patients - only reduce patient death rates in the short term, according to new research by The University of Manchester

A variety of programmes have been introduced in the UK over the past decade, with mixed results. Advancing Quality, a programme imported from the United States, was the first of these schemes to demonstrate a significant reduction in patient deaths.

It was introduced in the North West region of England in 2008. Previous research conducted at The University of Manchester showed Advancing Quality to have reduced patient deaths by 890 in the first 18 months of the policy's introduction.

But new research funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme published in the New England Journal of Medicine today demonstrates that while the quality of care continued to increase over the following two years, there was no further reduction in patient deaths in the region covered by the programme over that observed in the rest of England.

The study, looked at three conditions for which patients are admitted to hospital in an emergency; heart attack, pneumonia, and heart failure. Researchers from the University's Faculty of Medical and Human Sciences and Manchester Business School, along with the University of Warwick and University of Cambridge, examined deaths occurring within 30 days of admission to hospital, comparing the 24 hospitals in the North West with 137 in the rest of England.

Professor Matt Sutton, from The University of Manchester who led the previous study, said: "The earlier work found significant reductions in death rates in the short-term. Our latest research shows that in the longer-term, although death rates in the North West continued to fall, the reductions for the conditions linked to the incentives were no longer larger than the national trend."

Dr Søren Rud Kristensen, from The University of Manchester who led the current study, added: "These results suggest that the benefits of initiatives such as paying for performance may be temporary. Our findings could also be explained by the decision taken midway through the programme to change the incentives from bonuses for good performance to fines for failing to achieve targets.

"But we also found evidence to suggest that unintended but desirable spill-over effects may have occurred. These include improvements in the quality of care provided to both patients treated in hospitals in other regions, as well as patients admitted in the North West for conditions not covered by the incentive programme."
-end-


University of Manchester

Related Death Rates Articles from Brightsurf:

Death rates among people with severe COVID-19 drop by a half in England
Death rates from people with severe COVID-19 in hospital have dropped to around a half of the rate at the peak of the pandemic, new research has revealed.

Study helps explain declines in death rates from COVID-19
Fewer New Yorkers are dying from the coronavirus than health experts had anticipated, a new study shows.

Black patients have higher rates of death after PCI
Black patients who undergo percutaneous coronary intervention (PCI) are at an increased risk for major adverse outcomes, including death, compared to white patients, according to a study published today in JACC: Cardiovascular Interventions.

Study: Urban density not linked to higher coronavirus infection rates -- and is linked to lower COVID-19 death rates
A new study suggests that denser places, assumed by many to be more conducive to the spread of the coronavirus that causes COVID-19, are not linked to higher infection rates.

Stark disparities in COVID-19 hospitalization and death rates among New York
Researchers found that COVID-19 hospitalization and death rates varied across New York City boroughs.

Death rates from prostate cancer predicted to decline overall in EU but rise in Poland
Death rates from prostate cancer are predicted to fall in 2020 in the EU, largely due to better diagnosis and treatment, according to new research published in the leading cancer journal Annals of Oncology.

30-day death rates after emergency department visits
Researchers used Medicare data from 2009 to 2016 to see how 30-day death rates associated with emergency department visits have changed.

First ever state sepsis regulation in US tied to lower death rates
Death rates from sepsis fell faster in New York than expected -- and faster than in peer states -- following the introduction of the nation's first state-mandated sepsis regulation, according to an analysis.

Death rates from cesarean section far higher in developing countries
Cesarean sections are disproportionately threatening the lives of women and babies in low and middle-income countries (LMIC), according to a study led by Queen Mary University of London.

States with fewer melanoma diagnoses have higher death rates
Researchers at University of Utah Health conducted a state-by-state analysis to understand the geographic disparities for patients diagnosed with melanoma.

Read More: Death Rates News and Death Rates Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.