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Evaluation of the effects of the French Pay-for-Performance program - IFAQ pilot study

Listed author(s):
  • Benoît Lalloué

    ()

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, IGR - Institut Gustave Roussy)

  • Shu Jiang

    ()

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, IGR - Institut Gustave Roussy)

  • Anne Girault

    ()

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Marie Ferrua

    ()

    (IGR - Institut Gustave Roussy)

  • Philippe Loirat

    ()

    (IGR - Institut Gustave Roussy, EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité)

  • Etienne Minvielle

    ()

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP], IGR - Institut Gustave Roussy)

Registered author(s):

    Objective Most studies showed no or little effect of pay-for-performance (P4P) programs on different outcomes. In France, the P4P program IFAQ was generalized to all acute care hospitals in 2016. A pilot study was launched in 2012 to design, implement and assess this program. This article aims to assess the immediate impact of the 2012–14 pilot study. Design and setting From nine process quality indicators (QIs), an aggregated score was constructed as the weighted average, taking into account both achievement and improvement. Among 426 eligible volunteer hospitals, 222 were selected to participate. Eligibility depended on documentation of QIs and results of hospital accreditation. Hospitals with scores above the median received a financial reward based on their ranking and budget. Several characteristics known to have an influence on P4P results (patient age, socioeconomic status, hospital activity, casemix and location) were used to adjust the models. Intervention To assess the effect of the program, comparison between the 185 eligible selected hospitals and the 192 eligible not selected volunteers were done using the difference-in-differences method. Results Whereas all hospitals improved from 2012 to 2014, the difference-in-differences effect was positive but not significant both in the crude (2.89, P = 0.29) and adjusted models (4.07, P = 0.12). Conclusion These results could be explained by several reasons: low level of financial incentives, unattainable goals, too short study period. However, the lack of impact for the first year should not undermine the implementation of other P4P programs. Indeed, the pilot study helped to improve the final model used for generalization.

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    File URL: https://hal.archives-ouvertes.fr/hal-01579386/document
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    Paper provided by HAL in its series Post-Print with number hal-01579386.

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    Date of creation: 30 Aug 2017
    Publication status: Published in International Journal for Quality in Health Care, Oxford University Press (OUP), 2017, <10.1093/intqhc/mzx111>
    Handle: RePEc:hal:journl:hal-01579386
    DOI: 10.1093/intqhc/mzx111
    Note: View the original document on HAL open archive server: https://hal.archives-ouvertes.fr/hal-01579386
    Contact details of provider: Web page: https://hal.archives-ouvertes.fr/

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