Impact of secondary care financial incentives on the quality of physical healthcare for people with psychosis: a longitudinal controlled study
File(s)BJPsych May 2019.docx (92.51 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
Background: Concerns have repeatedly been expressed about the quality of physical health care that people with psychosis receive.
Aims: To examine whether the introduction of a financial incentive for secondary care services led to improvements in the quality of physical health care for people with psychosis.
Method: Longitudinal data were collected over an eight-year period on the quality of physical health care that people with psychosis received from 56 Trusts in England before and after the introduction of the financial incentive. Control data were also collected from six Health Boards in Wales where a financial incentive was not introduced. We calculated the proportion of patients whose clinical records indicated that they had been screened for seven key aspects of physical health and whether they were offered interventions for problems identified during screening.
Results: Data from 17947 people collected prior to (2011 and 2013) and following (2017) the introduction of the financial incentive in 2014 showed that the proportion of patients who received high quality physical health care in England rose from 12.85% to 31.65% (difference = 18.80, 95% CI =17.37 - 20.21). The proportion of patients who received high quality physical health care in Wales during this period rose from 8.40% to 13.96% (difference = 5.56, 95% CI =1.33 - 10.10).
Conclusions: The results of this study suggest that financial incentives for secondary care mental health services are associated with marked improvements in the quality of care that patients receive. Further research is needed to examine their impact on aspects of care that are not incentivised.
Aims: To examine whether the introduction of a financial incentive for secondary care services led to improvements in the quality of physical health care for people with psychosis.
Method: Longitudinal data were collected over an eight-year period on the quality of physical health care that people with psychosis received from 56 Trusts in England before and after the introduction of the financial incentive. Control data were also collected from six Health Boards in Wales where a financial incentive was not introduced. We calculated the proportion of patients whose clinical records indicated that they had been screened for seven key aspects of physical health and whether they were offered interventions for problems identified during screening.
Results: Data from 17947 people collected prior to (2011 and 2013) and following (2017) the introduction of the financial incentive in 2014 showed that the proportion of patients who received high quality physical health care in England rose from 12.85% to 31.65% (difference = 18.80, 95% CI =17.37 - 20.21). The proportion of patients who received high quality physical health care in Wales during this period rose from 8.40% to 13.96% (difference = 5.56, 95% CI =1.33 - 10.10).
Conclusions: The results of this study suggest that financial incentives for secondary care mental health services are associated with marked improvements in the quality of care that patients receive. Further research is needed to examine their impact on aspects of care that are not incentivised.
Date Issued
2019-12
Date Acceptance
2019-06-02
Citation
British Journal of Psychiatry, 2019, 215 (6), pp.720-725
ISSN
0007-1250
Publisher
Cambridge University Press (CUP)
Start Page
720
End Page
725
Journal / Book Title
British Journal of Psychiatry
Volume
215
Issue
6
Copyright Statement
© The Royal College of Psychiatrists 2019. This paper has been accepted for publication and will appear in a revised form, subsequent to peer-review and/or editorial input by Cambridge University Press.
Subjects
Financial incentives
prevention
psychosis
screening
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Psychiatry
Publication Status
Published
Date Publish Online
2019-07-05