Financial Incentive Has No Effect on Hypertension Care

Pay for performance also has no perceptible effects on incidence of stroke, MI, or heart failure

THURSDAY, Jan. 27 (HealthDay News) -- Introduction of pay for performance had no effect on the processes of care or on hypertension-related clinical outcomes in the United Kingdom, according to a study published online Jan. 25 in BMJ.

Brian Serumaga, M.P.H., from the University of Nottingham Medical School in the United Kingdom, and colleagues reviewed data from 470,725 patients with hypertension diagnosed between 2000 and 2007 in the Healthy Improvement Network Database in the United Kingdom. Patients were assessed for 48 months prior to the implementation of the pay-for-performance incentive, and for 36 months following. Outcomes included blood pressure centiles, monitoring, control, and treatment intensity. Incidence of hypertension-related outcomes and all causes of mortality were compared in patients who started treatment during 2000, or in patients who started treatment in the six months prior to the introduction of the incentive.

The investigators found that after accounting for recent trends, there were no changes in blood pressure monitoring, control, or treatment intensity that could be attributed to pay for performance. In addition, the incentive had no effect on the cumulative incidence of stroke, myocardial infarction, renal failure, heart failure, or all causes of mortality, either in patients who began treatment in 2000 or in newly treated patients.

"Our study has shown that explicit financial incentives did not improve the quality of care and clinical outcomes for patients with hypertension in primary care in the United Kingdom," the authors write.

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