Economists and health experts from the Universities of Manchester, Nottingham, Birmingham and Cambridge examined the impact of pay-for-performance models on quality of care. The project was implemented at 24 NHS hospitals in 2008.
The researchers found that while pay-for-performance models seemed to have no impact on quality of care in the U.S., those models improved patient safety and quality in the U.K. Specifically, the pay-for-performance initiative was associated with saving nearly 900 lives over an 18-month period.
The researchers determined several factors may explain the different outcomes in the U.K.:
• The bonuses in the U.K. were larger than in the U.S. and there was a greater probability of earning a bonus.
• Despite the competitive nature of the program, staff met regularly within the region to share problems and ideas of best practice.
• In the U.S., these schemes are voluntary and only 5 percent of hospitals take part, whereas all hospitals in the North West of England took part in the scheme.
The researchers concluded that the impact of pay-for-performance models depends on how these programs are designed and implemented.
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