Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: Controlled longitudinal study

BMJ (Online)

Volumn 349, Issue , 2014, Pages

  Harrison, Mark J ^a,b,c   Dusheiko, Mark ^d,e   Sutton, Matt ^a   Gravelle, Hugh ^b   Doran, Tim ^d   Roland, Martin ^f  

^a UNIVERSITY OF MANCHESTER   (United Kingdom)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^c ST PAUL S HOSPITAL   (Canada)

^d UNIVERSITY OF YORK   (United Kingdom)

^e UNIVERSITY OF LAUSANNE   (Switzerland)

^f UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

AMBULATORY CARE SENSITIVE CONDITION; ARTICLE; CHRONIC DISEASE; CONTROLLED STUDY; COST CONTROL; ENGLAND; HEALTH CARE QUALITY; HOSPITAL ADMISSION; HUMAN; LONGITUDINAL STUDY; OBSERVATIONAL STUDY; OUTCOME ASSESSMENT; PERFORMANCE SCHEME; PERSONNEL MANAGEMENT; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; SOCIAL STATUS; WORKMAN COMPENSATION; AMBULATORY CARE; ECONOMICS; HOSPITALIZATION; PRIMARY HEALTH CARE; REIMBURSEMENT; STATISTICS AND NUMERICAL DATA; UNITED KINGDOM;

AMBULATORY CARE; ENGLAND; HOSPITALIZATION; LONGITUDINAL STUDIES; OUTCOME ASSESSMENT (HEALTH CARE); PRIMARY HEALTH CARE; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE;

EID: 84925255151     PISSN: 09598146     EISSN: 17561833     Source Type: Journal    
DOI: 10.1136/bmj.g6423     Document Type: Article

References (46)

1. Rosenthal MB, Frank RG, Li Z, Epstein AM. Early experience with pay-for-performance: from concept to practice. JAMA 2005;294:1788-93.
2. Damberg CL, Raube K, Teleki SS, Dela CE. Taking stock of pay-for-performance: a candid assessment from the front lines. Health Aff (Millwood) 2009;28:517-25.
3. Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of pay for performance on the quality of primary care in England. N Engl J Med 2009;361:368-78.
4. Sutton M, Elder R, Guthrie B, Watt G. Record rewards: the effects of targeted quality incentives on the recording of risk factors by primary care providers. Health Econ 2010;19:1-13.
5. Emmert M, Eijkenaar F, Kemter H, Esslinger AS, Schoffski O. Economic evaluation of pay-for-performance in health care: a systematic review. Eur J Health Econ 2012;13:755-67.
6. Kruse GB, Polsky D, Stuart EA, Werner RM. The impact of hospital pay-for-performance on hospital and Medicare costs. Health Serv Res 2012;47:2118-36.
7. Mitchell C, Dwyer R, Hagan T, Mathers N. Impact of the QOF and the NICE guideline in the diagnosis and management of depression: a qualitative study. Br J Gen Pract 2011;61:e279-89.
8. Doran T, Kontopantelis E, Valderas JM, Campbell S, Roland M, Salisbury C, et al. Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. BMJ 2011;342:d3590.
9. Christianson J, Leatherman S, Sutherland K. Financial incentives, healthcare providers and quality improvements: a review of the evidence. Health Foundation, 2009.
10. Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review. Ann Fam Med 2012;10:461-8.
11. Flodgren G, Eccles MP, Shepperd S, Scott A, Parmelli E, Beyer FR. An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. Cochrane Database Syst Rev 2011;7:CD009255.
12. Chen JY, Tian H, Taira JD, Hodges KA, Brand JC, Chung RS, et al. The effect of a PPO pay-for-performance program on patients with diabetes. Am J Manag Care 2010;16:e11-9.
13. Fiorentini G, Iezzi E, Lippi BM, Ugolini C. Incentives in primary care and their impact on potentially avoidable hospital admissions. Eur J Health Econ 2011;12:297-309.
14. Martin S, Smith P, Gravelle H, Rice N. Do quality improvements in primary care reduce secondary care costs? Health Foundation, 2011.
15. Chen JY, Tian H, Juarez DT, Yermilov I, Braithwaite RS, Hodges KA, et al. Does pay for performance improve cardiovascular care in a "real-world" setting? Am J Med Qual 2011;26:340-8.
16. Chang RE, Lin SP, Aron DC. A pay-for-performance program in Taiwan improved care for some diabetes patients, but doctors may have excluded sicker ones. Health Aff (Millwood) 2012;31:93-102.
17. Sutton M, Nikolova S, Boaden R, Lester H, McDonald R, Roland M. Reduced mortality with hospital pay for performance in England. N Engl J Med 2012;367:1821-8.
18. Houle SK, McAlister FA, Jackevicius CA, Chuck AW, Tsuyuki RT. Does performance-based remuneration for individual health care practitioners affect patient care?: a systematic review. Ann Intern Med 201218;157:889-99.
19. Werner RM, Dudley RA. Making the 'pay' matter in pay-for-performance: implications for payment strategies. Health Aff (Millwood) 2009 September;28(5):1498-508.
20. Conrad DA, Perry L. Quality-based financial incentives in health care: can we improve quality by paying for it? Annu Rev Public Health 2009;30:357-71.
21. Van HP, De SD, Annemans L, Remmen R, Rosenthal MB, Sermeus W. Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Serv Res 2010;10:247.
22. Roland M. Pay-for-performance: not a magic bullet. Ann Intern Med 2012;157:912-3.
23. Chernew ME, Mechanic RE, Landon BE, Safran DG. Private-payer innovation in Massachusetts: the 'alternative quality contract'. Health Aff (Millwood) 2011;30:51-61.
24. Song Z, Safran DG, Landon BE, He Y, Ellis RP, Mechanic RE, et al. Health care spending and quality in year 1 of the alternative quality contract. N Engl J Med 2011;365:909-18.
25. Blunt I, Bardsley M, Dixon J. Trends in emergency admissions in England 2004-2009. Nuffield Trust; 2010.
26. Roland M. Linking physicians' pay to the quality of care-a major experiment in the United Kingdom. N Engl J Med 2004;351:1448-54.
27. Roland M, Campbell S. Successes and failures of the United Kingdom's pay for performance program. N Engl J Med 2014;370:1944-9.
28. Purdy S, Griffin T, Salisbury C, Sharp D. Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians. Public Health 2009;123:169-73.
29. Dusheiko M, Doran T, Gravelle H, Fullwood C, Roland M. Does higher quality of diabetes management in family practice reduce unplanned hospital admissions? Health Serv Res 2011;46(1 Pt 1):27-46.
30. Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Ther 2002;27:299-309.
31. Office for National Statistics. Population estimates for England and Wales, mid-2011 (2011 Census-based). ONS, 2012.
32. Tian Y, Dixon A, Gao H. Emergency hospital admissions for ambulatory care-sensitive conditions: identifying the potential for reductions. King's Fund, 2012.
33. Van Walraven C, Bennett C, Jennings A, Austin PC, Forster AJ. Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ 2011;183:E391-E402.
34. Durojaiye LI, Hutchison T, Madeley RJ. Improved primary care does not prevent the admission of children to hospital. Public Health 1989;103:181-8.
35. Weinberger M, Oddone EZ, Henderson WG. Does increased access to primary care reduce hospital readmissions? Veterans Affairs Cooperative Study Group on Primary Care and Hospital Readmission. N Engl J Med 1996;334:1441-7.
36. Bottle A, Gnani S, Saxena S, Aylin P, Mainous AG, Majeed A. Association between quality of primary care and hospitalization for coronary heart disease in England: National cross-sectional study. J Gen Intern Med 2008;23:135-41.
37. Purdy S, Griffin T, Salisbury C, Sharp D. Emergency respiratory admissions: influence of practice, population and hospital factors. J Health Serv Res Policy 2011;16:133-40.
38. Calderon-Larranaga A, Carney L, Soljak M, Bottle A, Partridge M, Bell D, et al. Association of population and primary healthcare factors with hospital admission rates for chronic obstructive pulmonary disease in England: national cross-sectional study. Thorax 2011;66:191-6.
39. Kiran T, Hutchings A, Dhalla IA, Furlong C, Jacobson B. The association between quality of primary care, deprivation and cardiovascular outcomes: a cross-sectional study using data from the UK Quality and Outcomes Framework. J Epidemiol Community Health 2010;64:927-34.
40. Soljak M, Calderon-Larrañaga A, Sharma P, Cecil E, Bell D, Abi-Aad G, et al. Does higher quality primary health care reduce stroke admissions? A national cross-sectional study. Br J Gen Pract 2011;61:e801-7.
41. Serumaga B, Ross-Degnan D, Avery AJ, Elliott RA, Majumdar SR, Zhang F, et al. Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study. BMJ 2011;342:d108.
42. Simpson CR, Hannaford PC, Ritchie LD, Sheikh A, Williams D. Impact of the pay-for-performance contract and the management of hypertension in Scottish primary care: a 6-year population-based repeated cross-sectional study. Br J Gen Pract 2011;61:e443-51.
43. Fleetcroft R, Parekh-Bhurke S, Howe A, Cookson R, Swift L, Steel N. The UK pay-for-performance programme in primary care: estimation of population mortality reduction. Br J Gen Pract 2010;60:e345-52.
44. National Audit Office. Emergency admissions to hospital: managing the demand. Stationery Office, 2013.
45. Department of Health. Department of Health National Framework for Coronary Heart Disease. DoH, 2000.
46. Oxman AD, Thomson MA, Davis DA, Haynes RB. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ 1995;153:1423-31.