Effect on hospital incentive payments and quality performance of a hospital pay for performance (P4P) programme in Belgium

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES
J. Brouwers , D. Seys , F. Claessens , A. Van Wilder , L. Bruyneel , D. De Ridder , K. Eeckloo , K. Vanhaecht
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引用次数: 0

Abstract

Background

Belgium initiated a hospital pay for performance (P4P) programme after a decade of fixed bonus budgets for “quality and safety contracts”. This study examined the effect of P4P on hospital incentive payments, performance on quality measures, and the association between changes in quality performance and incentive payments over time.

Methods

The Belgian government provided information on fixed bonus budgets in 2013–2017 and hospital incentive payments as well as hospital performance on quality measures for the P4P programmes in 2018–2020. Descriptive analyses were conducted to map the financial repercussion between the two systems. A difference-in-difference analysis evaluated the association between quality indicator performance and received incentive payments over time.

Results

Data from 87 acute-care hospitals were analyzed. In the transition to a P4P programme, 29% of hospitals received lower incentive payments per bed. During the P4P years, quality performance scores increased yearly for 55% of hospitals and decreased yearly for 5% of hospitals. There was a significant larger drop in incentive payments for hospitals that scored above median with the start of the P4P programme.

Conclusions

The transition from fixed bonus budgets for quality efforts to a new incentive payment in a P4P programme has led to more hospitals being financially impacted, although the effect is marginal given the small P4P budget. Quality indicators seem to improve over the years, but this does not correlate with an increase in reward per bed for all hospitals due to the closed nature of the budget.

比利时医院绩效工资(P4P)计划对医院奖励金和质量绩效的影响
背景比利时在为 "质量和安全合同 "提供了十年的固定奖金预算后,启动了医院绩效薪酬(P4P)计划。本研究探讨了 P4P 对医院奖励金、质量指标绩效的影响,以及质量指标绩效变化与奖励金随时间推移的关联。方法 比利时政府提供了 2013-2017 年固定奖金预算、2018-2020 年医院奖励金以及 P4P 计划医院质量指标绩效的信息。我们进行了描述性分析,以绘制两种制度之间的财务反响图。一项差异分析评估了质量指标表现与获得的奖励金之间的关联。在向 P4P 计划过渡的过程中,29% 的医院每张病床获得的奖励金较低。在实施 P4P 计划期间,55% 的医院的质量绩效得分逐年上升,5% 的医院得分逐年下降。结论:从固定的质量奖励预算到新的奖励金,"先诊疗后付费 "项目的过渡使更多的医院在财务上受到了影响,尽管由于 "先诊疗后付费 "项目的预算较少,这种影响微乎其微。几年来,质量指标似乎有所改善,但由于预算的封闭性,这与所有医院每张病床奖励的增加并不相关。
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来源期刊
CiteScore
1.70
自引率
8.30%
发文量
83
审稿时长
57 days
期刊介绍: Revista de Calidad Asistencial (Quality Healthcare) (RCA) is the official Journal of the Spanish Society of Quality Healthcare (Sociedad Española de Calidad Asistencial) (SECA) and is a tool for the dissemination of knowledge and reflection for the quality management of health services in Primary Care, as well as in Hospitals. It publishes articles associated with any aspect of research in the field of public health and health administration, including health education, epidemiology, medical statistics, health information, health economics, quality management, and health policies. The Journal publishes 6 issues, exclusively in electronic format. The Journal publishes, in Spanish, Original works, Special and Review Articles, as well as other sections. Articles are subjected to a rigorous, double blind, review process (peer review)
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