Pay-for-performance programs – which reward hospitals financially for improving the quality of care provided to patients – only reduce patient death rates in the short term, according to UK research published in the New England Journal of Medicine.
A variety of programs have been introduced in the UK over the past decade, with mixed results, the authors reported. Advancing Quality, a program imported from the United States, was the first of these schemes to demonstrate a significant reduction in patient deaths.
It was introduced in the northwest 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 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 program 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 examined deaths occurring within 30 days of admission to hospital, comparing the 24 hospitals in the Northwest with 137 in the rest of England.
