IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v143y2024ics0168851024000617.html
   My bibliography  Save this article

Pay-for-performance and patient safety in acute care: A systematic review

Author

Listed:
  • Slawomirski, Luke
  • Hensher, Martin
  • Campbell, Julie
  • deGraaff, Barbara

Abstract

Pay-for-performance (p4p) has been tried in all healthcare settings to address ongoing deficiencies in the quality and outcomes of care. The evidence for the effect of these policies has been inconclusive, especially in acute care. This systematic review focused on patient safety p4p in the hospital setting. Using the PRISMA guidelines, we searched five biomedical databases for quantitative studies using at least one outcome metric from database inception to March 2023, supplemented by reference tracking and internet searches. We identified 6,122 potential titles of which 53 were included: 39 original investigations, eight literature reviews and six grey literature reports. Only five system-wide p4p policies have been implemented, and the quality of evidence was low overall. Just over half of the studies (52 %) included failed to observe improvement in outcomes, with positive findings heavily skewed towards poor quality evaluations. The exception was the Fragility Hip Fracture Best Practice Tariff (BPT) in England, where sustained improvement was observed across various evaluations. All policies had a miniscule impact on total hospital revenue. Our findings underscore the importance of simple and transparent design, involvement of the clinical community, explicit links to other quality improvement initiatives, and gradual implementation of p4p initatives. We also propose a research agenda to lift the quality of evidence in this field.

Suggested Citation

  • Slawomirski, Luke & Hensher, Martin & Campbell, Julie & deGraaff, Barbara, 2024. "Pay-for-performance and patient safety in acute care: A systematic review," Health Policy, Elsevier, vol. 143(C).
  • Handle: RePEc:eee:hepoli:v:143:y:2024:i:c:s0168851024000617
    DOI: 10.1016/j.healthpol.2024.105051
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851024000617
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.healthpol.2024.105051?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Anne Girault & Martine Bellanger & Benoît Lalloué & Philippe Loirat & Jean-Claude Moisdon & Etienne Minvielle, 2017. "Implementing hospital pay-for-performance: Lessons learned from the French pilot program," Post-Print hal-01464478, HAL.
    2. Girault, Anne & Bellanger, Martine & Lalloué, Benoît & Loirat, Philippe & Moisdon, Jean-Claude & Minvielle, Etienne, 2017. "Implementing hospital pay-for-performance: Lessons learned from the French pilot program," Health Policy, Elsevier, vol. 121(4), pages 407-417.
    3. Rachel Meacock & Søren Rud Kristensen & Matt Sutton, 2014. "The Cost‐Effectiveness Of Using Financial Incentives To Improve Provider Quality: A Framework And Application," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 1-13, January.
    4. Milstein, Ricarda & Schreyoegg, Jonas, 2016. "Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries," Health Policy, Elsevier, vol. 120(10), pages 1125-1140.
    5. Ane Auraaen & Luke Slawomirski & Niek Klazinga, 2018. "The economics of patient safety in primary and ambulatory care: Flying blind," OECD Health Working Papers 106, OECD Publishing.
    6. Spaulding, Aaron & Zhao, Mei & Haley, D. Rob, 2014. "Value-based purchasing and hospital acquired conditions: Are we seeing improvement?," Health Policy, Elsevier, vol. 118(3), pages 413-421.
    7. Luke Slawomirski & Niek Klazinga, 2022. "The economics of patient safety: From analysis to action," OECD Health Working Papers 145, OECD Publishing.
    8. Matthew J Page & Joanne E McKenzie & Patrick M Bossuyt & Isabelle Boutron & Tammy C Hoffmann & Cynthia D Mulrow & Larissa Shamseer & Jennifer M Tetzlaff & Elie A Akl & Sue E Brennan & Roger Chou & Jul, 2021. "The PRISMA 2020 statement: An updated guideline for reporting systematic reviews," PLOS Medicine, Public Library of Science, vol. 18(3), pages 1-15, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nadja Kairies-Schwarz & Claudia Souček, 2020. "Performance Pay in Hospitals: An Experiment on Bonus–Malus Incentives," IJERPH, MDPI, vol. 17(22), pages 1-29, November.
    2. Brosig-Koch, Jeannette & Groß, Mona & Hennig-Schmidt, Heike & Kairies-Schwarz, Nadja & Wiesen, Daniel, 2021. "Physicians' incentives, patients' characteristics, and quality of care: A systematic experimental comparison of fee-for-service, capitation, and pay for performance," Ruhr Economic Papers 923, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    3. Feng, Yan & Kristensen, Søren Rud & Lorgelly, Paula & Meacock, Rachel & Sanchez, Marina Rodes & Siciliani, Luigi & Sutton, Matt, 2019. "Pay for performance for specialised care in England: Strengths and weaknesses," Health Policy, Elsevier, vol. 123(11), pages 1036-1041.
    4. Field, Robert I. & Keller, Catherine & Louazel, Michel, 2020. "Can governments push providers to collaborate? A comparison of hospital network reforms in France and the United States," Health Policy, Elsevier, vol. 124(10), pages 1100-1107.
    5. Minvielle, E. & Fierobe, A. & Fourcade, A. & Ferrua, M. & di Palma, M. & Scotté, F. & Mir, O., 2023. "The use of patient-reported outcome and experience measures for health policy purposes: A scoping review in oncology," Health Policy, Elsevier, vol. 129(C).
    6. Rizkiana Sidqiyatul Hamdani & Sudharto Prawata Hadi & Iwan Rudiarto, 2021. "Progress or Regress? A Systematic Review on Two Decades of Monitoring and Addressing Land Subsidence Hazards in Semarang City," Sustainability, MDPI, vol. 13(24), pages 1-26, December.
    7. Boglárka Anna Éliás & Attila Jámbor, 2021. "Food Security and COVID-19: A Systematic Review of the First-Year Experience," Sustainability, MDPI, vol. 13(9), pages 1-18, May.
    8. Omoyele, Olalekan & Hoffmann, Maximilian & Koivisto, Matti & Larrañeta, Miguel & Weinand, Jann Michael & Linßen, Jochen & Stolten, Detlef, 2024. "Increasing the resolution of solar and wind time series for energy system modeling: A review," Renewable and Sustainable Energy Reviews, Elsevier, vol. 189(PB).
    9. Cala, Anggie & Maturana-Córdoba, Aymer & Soto-Verjel, Joseph, 2023. "Exploring the pretreatments' influence on pressure reverse osmosis: PRISMA review," Renewable and Sustainable Energy Reviews, Elsevier, vol. 188(C).
    10. Ming Shan & Yu-Shan Li & Bon-Gang Hwang & Jia-En Chua, 2021. "Productivity Metrics and Its Implementations in Construction Projects: A Case Study of Singapore," Sustainability, MDPI, vol. 13(21), pages 1-19, November.
    11. Susca, T. & Zanghirella, F. & Colasuonno, L. & Del Fatto, V., 2022. "Effect of green wall installation on urban heat island and building energy use: A climate-informed systematic literature review," Renewable and Sustainable Energy Reviews, Elsevier, vol. 159(C).
    12. Alexander P. L. Martindale & Carrie D. Llewellyn & Richard O. Visser & Benjamin Ng & Victoria Ngai & Aditya U. Kale & Lavinia Ferrante Ruffano & Robert M. Golub & Gary S. Collins & David Moher & Melis, 2024. "Concordance of randomised controlled trials for artificial intelligence interventions with the CONSORT-AI reporting guidelines," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    13. Gizéh Rangel-de Lázaro & Josep M. Duart, 2023. "You Can Handle, You Can Teach It: Systematic Review on the Use of Extended Reality and Artificial Intelligence Technologies for Online Higher Education," Sustainability, MDPI, vol. 15(4), pages 1-23, February.
    14. Kim, Hyunil & Kim, Yun Young & Song, Eun-Jee & Windsor, Liliane, 2024. "Policies to reduce child poverty and child maltreatment: A scoping review and preliminary estimates of indirect effects," Children and Youth Services Review, Elsevier, vol. 156(C).
    15. Lee, Kuan-Ting & Chen, Yen-Chin & Yang, Yi-Ching & Wang, Wei-Li, 2024. "On practicing magicine, from wonder to care: A systematic review of studies that apply magic in healthcare," Social Science & Medicine, Elsevier, vol. 341(C).
    16. Robert Messerle & Jonas Schreyögg, 2024. "Country-level effects of diagnosis-related groups: evidence from Germany’s comprehensive reform of hospital payments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(6), pages 1013-1030, August.
    17. Deniz Dutz & Ingrid Huitfeldt & Santiago Lacouture & Magne Mogstad & Alexander Torgovitsky & Winnie van Dijk, 2021. "Selection in Surveys," NBER Working Papers 29549, National Bureau of Economic Research, Inc.
      • Deniz Dutz & Ingrid Huitfeldt & Santiago Lacouture & Magne Mogstad & Alexander Torgovitsky & Winnie van Dijk, 2021. "Selection in Surveys," Discussion Papers 971, Statistics Norway, Research Department.
    18. Lemesa Hirpe & Chunho Yeom, 2021. "Municipal Solid Waste Management Policies, Practices, and Challenges in Ethiopia: A Systematic Review," Sustainability, MDPI, vol. 13(20), pages 1-16, October.
    19. Simmons, Cassandra & Pot, Mirjam & Lorenz-Dant, Klara & Leichsenring, Kai, 2024. "Disentangling the impact of alternative payment models and associated service delivery models on quality of chronic care: A scoping review," Health Policy, Elsevier, vol. 143(C).
    20. Ellen Busink & Dana Kendzia & Fatih Kircelli & Sophie Boeger & Jovana Petrovic & Helen Smethurst & Stephen Mitchell & Christian Apel, 2023. "A systematic review of the cost-effectiveness of renal replacement therapies, and consequences for decision-making in the end-stage renal disease treatment pathway," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(3), pages 377-392, April.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:143:y:2024:i:c:s0168851024000617. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.