Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study

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dc.contributor.authorSerumaga, Brian
dc.contributor.authorRoss-Degnan, Dennis
dc.contributor.authorElliott, Rachel A.
dc.contributor.authorMajumdar, Sumit R.
dc.contributor.authorZhang, Fang
dc.contributor.authorSoumerai, Stephen B.
dc.date.accessioned2023-09-26T18:42:57Z
dc.date.available2023-09-26T18:42:57Z
dc.date.issued2011
dc.description.abstractSince 2000 the use of pay for performance policies that link a portion of doctors’ payment to measures of healthcare quality has increased rapidly. Both governments and private payers have promoted pay for performance in the belief that economic incentives can accelerate improvements in the quality and outcomes of care. Surprisingly, there is little rigorous evidence to support or refute use of these policies.1 Indeed, pay for performance schemes may result in unintended outcomes as a result of adverse selection, such as the exclusion of severely ill patients from care. The impacts of pay for performance on the quality and outcomes of care for common chronic conditions such as hypertension are largely unknown. The prevalence of hypertension among those over age 50 is about 50%; hypertension is among the most treatable, but undertreated, of cardiovascular risk factors.5 Studies indicate consistently that one third of people with a known diagnosis of hypertension are either untreated or uncontrolled.6 7 Better control of hypertension on a population-wide basis could yield substantial reductions in morbidity and premature mortality,6 8 and this also makes it an attractive target for pay for performance. We studied a large scale pay for performance policy in the four countries of the United Kingdom (England, Scotland, Wales, and Northern Ireland), which targeted several chronic diseases in primary care, and evaluated its impact on the management and outcomes of hypertension. Based on the proportion of patients achieving certain quality indicators, general practitioners could receive payments as high as 25% of their total income.9 The programme started in April 2004 and included 136 quality indicators, including five for hypertension (see web extra), one of which was the proportion of patients with blood pressures controlled to 150/90 mm Hg or less.en_US
dc.identifier.citationSerumaga, B., Ross-Degnan, D., Avery, A. J., Elliott, R. A., Majumdar, S. R., Zhang, F., & Soumerai, S. B. (2011). Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study. Bmj, 342.https://doi.org/10.1136/bmj.d108https://doi.org/10.1136/bmj.d108en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9273
dc.language.isoenen_US
dc.publisherBmjen_US
dc.subjectBlood pressure controlen_US
dc.subjectHypertensionen_US
dc.subjectPerformance policiesen_US
dc.titleEffect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series studyen_US
dc.typeArticleen_US
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