Impact of Pay for Performance in the Emergency Department on Costs and Outcomes of Percutaneous Coronary Intervention
| Autor: | Ji-Syuan Wu, 吳季軒 |
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| Rok vydání: | 2016 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 104 Background：Heart disease was ranked second in the top ten leading causes of death in Taiwan in 2014. To encourage medical service providers in providing holistic medical care, hospital administrators have increasingly emphasized pay for performance. Taiwan implemented a project in May 2012, aiming to elevate the quality of emergency department (ED) care covered by the National Health Insurance. Specifically, financial incentives were formulated in an attempt to enhance ED quality of care for patients with acute myocardial infarction (AMI). Currently, few studies have examined the project, and no study has explored the project’s influence on the medical costs and care outcomes of patients with AMI who have received percutaneous coronary intervention(PCI). Objective：To research the impact of the P4P program in the ED on costs and outcomes of PCI. Method：This study used the 2005 claim data of the National Health Insurance Research Database of 1 million beneficiaries for secondary data analyses. The data of patients with AMI who have received PCI between 2008 and the third quarter of 2013 were retrieved. A segmented generalized estimating equation was used to investigate the influence of the project aimed at enhancing ED care quality on the medical costs and care outcomes of patients with AMI who have received PCI. Results：There are no significant improvements in hospitalization cost, 30-day mortality and all cause 30-day readmission after implementing P4P program in the ED. Conclusion：There are no significant improvements after the implementation of P4P program in the ED on costs and outcomes of PCI. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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