Abstract
Objective: In Korea, the Value Incentive Program (VIP) was first applied to selected clinical conditions in 2007 to evaluate the performance of medical institutes. We examined whether the conditionspecific performance of the VIP resulted in measurable improvement in quality of care and in reduced medical costs. Design: Population-based retrospective observational study. Setting: We used two data set including the results of quality assessment and hospitalization data from National Health Claim data from 2011 to 2014. Participants: Participants who were admitted to the hospital for obstetrics and gynecology were included. A total of 535 289 hospitalizations were included in our analysis. Methods: We used a generalized estimating equation (GEE) model to identify associations between the quality assessment and length of stay (LOS). A GEE model based on a gamma distribution was used to evaluate medical cost. The Poisson regression analysis was used to evaluate readmission. Main Outcome Measures: The outcome variables included LOS, medical costs and readmission within 30 days. Results: Higher condition-specific performance by VIP participants was associated with shorter LOSs, decreases in medical cost, and lower within 30-day readmission rates for target and nontarget surgeries. LOS and readmission within 30 days were different by change in quality assessment at each medical institute. Conclusions: Our findings contribute to the body of evidence used by policy-makers for expansion and development of the VIP. The study revealed the positive effects of quality assessment on quality of care. To reduce the between-institute quality gap, alternative strategies are needed for medical institutes that had low performance.
| Original language | English |
|---|---|
| Article number | mzw159 |
| Pages (from-to) | 222-227 |
| Number of pages | 6 |
| Journal | International Journal for Quality in Health Care |
| Volume | 29 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2017 Apr 1 |
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All Science Journal Classification (ASJC) codes
- Health Policy
- Public Health, Environmental and Occupational Health
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Pay-for-performance reduces healthcare spending and improves quality of care : Analysis of target and non-target obstetrics and gynecology surgeries. / Kim, Seung Ju; Han, Kyu Tae; Kim, Sun Jung; Park, Euncheol.
In: International Journal for Quality in Health Care, Vol. 29, No. 2, mzw159, 01.04.2017, p. 222-227.Research output: Contribution to journal › Article
TY - JOUR
T1 - Pay-for-performance reduces healthcare spending and improves quality of care
T2 - Analysis of target and non-target obstetrics and gynecology surgeries
AU - Kim, Seung Ju
AU - Han, Kyu Tae
AU - Kim, Sun Jung
AU - Park, Euncheol
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective: In Korea, the Value Incentive Program (VIP) was first applied to selected clinical conditions in 2007 to evaluate the performance of medical institutes. We examined whether the conditionspecific performance of the VIP resulted in measurable improvement in quality of care and in reduced medical costs. Design: Population-based retrospective observational study. Setting: We used two data set including the results of quality assessment and hospitalization data from National Health Claim data from 2011 to 2014. Participants: Participants who were admitted to the hospital for obstetrics and gynecology were included. A total of 535 289 hospitalizations were included in our analysis. Methods: We used a generalized estimating equation (GEE) model to identify associations between the quality assessment and length of stay (LOS). A GEE model based on a gamma distribution was used to evaluate medical cost. The Poisson regression analysis was used to evaluate readmission. Main Outcome Measures: The outcome variables included LOS, medical costs and readmission within 30 days. Results: Higher condition-specific performance by VIP participants was associated with shorter LOSs, decreases in medical cost, and lower within 30-day readmission rates for target and nontarget surgeries. LOS and readmission within 30 days were different by change in quality assessment at each medical institute. Conclusions: Our findings contribute to the body of evidence used by policy-makers for expansion and development of the VIP. The study revealed the positive effects of quality assessment on quality of care. To reduce the between-institute quality gap, alternative strategies are needed for medical institutes that had low performance.
AB - Objective: In Korea, the Value Incentive Program (VIP) was first applied to selected clinical conditions in 2007 to evaluate the performance of medical institutes. We examined whether the conditionspecific performance of the VIP resulted in measurable improvement in quality of care and in reduced medical costs. Design: Population-based retrospective observational study. Setting: We used two data set including the results of quality assessment and hospitalization data from National Health Claim data from 2011 to 2014. Participants: Participants who were admitted to the hospital for obstetrics and gynecology were included. A total of 535 289 hospitalizations were included in our analysis. Methods: We used a generalized estimating equation (GEE) model to identify associations between the quality assessment and length of stay (LOS). A GEE model based on a gamma distribution was used to evaluate medical cost. The Poisson regression analysis was used to evaluate readmission. Main Outcome Measures: The outcome variables included LOS, medical costs and readmission within 30 days. Results: Higher condition-specific performance by VIP participants was associated with shorter LOSs, decreases in medical cost, and lower within 30-day readmission rates for target and nontarget surgeries. LOS and readmission within 30 days were different by change in quality assessment at each medical institute. Conclusions: Our findings contribute to the body of evidence used by policy-makers for expansion and development of the VIP. The study revealed the positive effects of quality assessment on quality of care. To reduce the between-institute quality gap, alternative strategies are needed for medical institutes that had low performance.
UR - http://www.scopus.com/inward/record.url?scp=85019185266&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019185266&partnerID=8YFLogxK
U2 - 10.1093/intqhc/mzw159
DO - 10.1093/intqhc/mzw159
M3 - Article
VL - 29
SP - 222
EP - 227
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
SN - 1353-4505
IS - 2
M1 - mzw159
ER -