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Effect of Pay-For-Outcomes and Encouraging New Providers on National Health Service Smoking Cessation Services in England: A Cluster Controlled Study

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  • Hugh McLeod
  • Deirdre Blissett
  • Steven Wyatt
  • Mohammed A Mohammed

Abstract

Background: Payment incentives are known to influence healthcare but little is known about the impact of paying directly for achieved outcomes. In England, novel purchasing (commissioning) of National Health Service (NHS) stop smoking services, which paid providers for quits achieved whilst encouraging new market entrants, was implemented in eight localities (primary care trusts (PCTs)) in April 2010. This study examines the impact of the novel commissioning on these services. Methods: Accredited providers were paid standard tariffs for each smoker who was supported to quit for four and 12 weeks. A cluster-controlled study design was used with the eight intervention PCTs (representing 2,138,947 adult population) matched with a control group of all other (n=64) PCTs with similar demographics which did not implement the novel commissioning arrangements. The primary outcome measure was changes in quits at four weeks between April 2009 and March 2013. A secondary outcome measure was the number of new market entrants within the group of the largest two providers at PCT-level. Results: The number of four-week quits per 1,000 adult population increased per year on average by 9.6% in the intervention PCTs compared to a decrease of 1.1% in the control PCTs (incident rate ratio 1∙108, p

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  • Hugh McLeod & Deirdre Blissett & Steven Wyatt & Mohammed A Mohammed, 2015. "Effect of Pay-For-Outcomes and Encouraging New Providers on National Health Service Smoking Cessation Services in England: A Cluster Controlled Study," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-15, April.
    • Handle: RePEc:plo:pone00:0123349
    DOI: 10.1371/journal.pone.0123349
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    References listed on IDEAS

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    1. Martin Emmert & Frank Eijkenaar & Heike Kemter & Adelheid Esslinger & Oliver Schöffski, 2012. "Economic evaluation of pay-for-performance in health care: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 755-767, December.
    2. Marini, Giorgia & Street, Andrew, 2007. "A transaction costs analysis of changing contractual relations in the English NHS," Health Policy, Elsevier, vol. 83(1), pages 17-26, September.
    3. Alan Maynard, 2012. "The powers and pitfalls of payment for performance," Health Economics, John Wiley & Sons, Ltd., vol. 21(1), pages 3-12, January.
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