Should hospitals have cash incentives to reduce death rates?

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Long term effects of monetary bonus dwindling

Researchers have found that the Advancing Quality scheme, which uses financial incentives to reduce hospital death rates, has seen it’s initial success begin to falter.

Under the scheme, 24 hospitals based in the North West of England were offered financial rewards for reducing the number of patients dying within 30 days of admission. Over the first 18 months, results showed the death rate drop considerably, however this has now tailed off according to experts.

Dwindling success rates

Matt Sutton, Manchester University professor and study author, told the HSJ that early results proved “significant reductions in death rates in the short term” however the continuing drop “was no longer larger than the national trend.” One potential cause for the plateau was pinpointed as the 2010 switch to a penalty scheme instead of a bonus driven one, although no evidence was found to show that people were treated any differently.

Funded by the National Institute for Health Research, the research examined 1.8 million emergency admissions for heart attacks, pneumonia and heart failure. Carried out by the universities of Cambridge, Manchester and Warwick, it compared the number of deaths occurring within 30 days of admission at the 24 North West Hospitals.