Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study.

Autor: Khedmati Morasae E; University of Exeter Business School, Exeter, UK., Rose TC; University of Liverpool, Liverpool, UK., Gabbay M; University of Liverpool, Liverpool, UK., Buckels L; Liverpool Clinical Commissioning Group, Liverpool, UK., Morris C; Liverpool Clinical Commissioning Group, Liverpool, UK., Poll S; Liverpool Clinical Commissioning Group, Liverpool, UK., Goodall M; University of Liverpool, Liverpool, UK., Barnett R; Liverpool Local Medical Committee, Liverpool, UK., Barr B; University of Liverpool, Liverpool, UK.
Jazyk: angličtina
Zdroj: Medical care research and review : MCRR [Med Care Res Rev] 2022 Jun; Vol. 79 (3), pp. 394-403. Date of Electronic Publication: 2021 Jul 29.
DOI: 10.1177/10775587211035280
Abstrakt: National financial incentive schemes for improving the quality of primary care have come under criticism in the United Kingdom, leading to calls for localized alternatives. This study investigated whether a local general practice incentive-based quality improvement scheme launched in 2011 in a city in the North West of England was associated with a reduction in all-cause emergency hospital admissions. Difference-in-differences analysis was used to compare the change in emergency admission rates in the intervention city, to the change in a matched comparison population. Emergency admissions rates fell by 19 per 1,000 people in the years following the intervention (95% confidence interval [17, 21]) in the intervention city, relative to the comparison population. This effect was greater among more disadvantaged populations, narrowing socioeconomic inequalities in emergency admissions. The findings suggest that similar approaches could be an effective component of strategies to reduce unplanned hospital admissions elsewhere.
Databáze: MEDLINE