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

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MBS’ Ruth Boaden, alongside colleagues from The University of Manchester, University of Warwick and University of Cambridge, has published research demonstrating that 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.

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.

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