Evidence map›Paper›PMID 25160840›Full record

ArticleCirculation. Cardiovascular quality and outcomes2014

Access to coronary artery bypass graft surgery under pay for performance: evidence from the premier hospital quality incentive demonstration.

Arnold M Epstein, Karen E Joynt, Ashish K Jha, E John Orav

Open access · bronzeAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
3.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 6 citations in OpenAlex.

  1. Pay for performance for hospitals.The Cochrane database of systematic reviews · 2019
    Pooled it
  2. Design and effects of outcome-based payment models in healthcare: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019
    Pooled it
  3. The Cost of Complications Following Major Resection of Malignant Neoplasia.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018
    Article
  4. Pay-for-Performance: Disappointing Results or Masked Heterogeneity?Medical care research and review : MCRR · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Arnold M EpsteinFrom the Department of Health Policy and Management (A.M.E., K.E.J., A.K.J.) and Department of Biostatistics (E.J.O.), Harvard School of Public Health, Boston, MA; Department of Medicine, Division of General Medicine, (A.M.E., A.K.J., E.J.O.) and Division of Cardiovascular Medicine (K.E.J.), Brigham and Women's Hospital, Boston, MA; and Department of Medicine, VA Boston Healthcare System, Boston, MA (K.E.J., A.K.J.). aepstein@hsph.harvard.edu.
Karen E JoyntFrom the Department of Health Policy and Management (A.M.E., K.E.J., A.K.J.) and Department of Biostatistics (E.J.O.), Harvard School of Public Health, Boston, MA; Department of Medicine, Division of General Medicine, (A.M.E., A.K.J., E.J.O.) and Division of Cardiovascular Medicine (K.E.J.), Brigham and Women's Hospital, Boston, MA; and Department of Medicine, VA Boston Healthcare System, Boston, MA (K.E.J., A.K.J.).
Ashish K JhaFrom the Department of Health Policy and Management (A.M.E., K.E.J., A.K.J.) and Department of Biostatistics (E.J.O.), Harvard School of Public Health, Boston, MA; Department of Medicine, Division of General Medicine, (A.M.E., A.K.J., E.J.O.) and Division of Cardiovascular Medicine (K.E.J.), Brigham and Women's Hospital, Boston, MA; and Department of Medicine, VA Boston Healthcare System, Boston, MA (K.E.J., A.K.J.).
E John OravFrom the Department of Health Policy and Management (A.M.E., K.E.J., A.K.J.) and Department of Biostatistics (E.J.O.), Harvard School of Public Health, Boston, MA; Department of Medicine, Division of General Medicine, (A.M.E., A.K.J., E.J.O.) and Division of Cardiovascular Medicine (K.E.J.), Brigham and Women's Hospital, Boston, MA; and Department of Medicine, VA Boston Healthcare System, Boston, MA (K.E.J., A.K.J.).
Brigham and Women's Hospital · US

Funding

THE IMPACT OF PUBLIC REPORTING ON OUTCOMES AND CASE SELECTION FOR PCIK23HL109177 · NHLBI · WASHINGTON UNIVERSITY · PI JOYNT MADDOX, KAREN ELLEN · 2011 to 2017
$691k
NHLBI NIH HHS 1K23HL109177-01NHLBI NIH HHS K23 HL109177
6 · The paper itself

Abstract

backgroundAlthough pay for performance (P4P) has become common, many worry that P4P will lead providers to avoid offering surgical procedures to the sickest patients out of concern that poor outcomes will lead to financial penalties. METHODS AND

resultsWe used Medicare data to compare change in rates of coronary artery bypass graft surgery between 2002 to 2003 and 2008 to 2009 among patients with acute myocardial infarction (AMI) admitted to 126 hospitals participating in Medicare's Premier Hospital Quality Incentive Demonstration P4P program with patients in 848 control hospitals participating in public reporting through the Health Quality Alliance. We examined rates for all patients with AMI and those in the top decile of predicted mortality based on demographics, medical comorbidities, and AMI characteristics. We identified 91 393 patients admitted for AMI in Premier hospitals and 502 536 Medicare patients admitted for AMI in control hospitals. Coronary artery bypass graft surgery rates for patients with AMI in Premier decreased from 13.6% in 2002 to 2003 to 10.4% in 2008 to 2009; there was a comparable decrease in non-Premier hospitals (13.6%-10.6%; P value for comparison of changes between Premier and non-Premier, 0.67). Coronary artery bypass graft surgery rates for high-risk patients in Premier decreased from 8.4% in FY 2002 to 203 to 8.2% in 2008 to 2009. Patterns were similar in non-Premier hospitals (8.4%-8.3%; P value for comparison of changes between Premier and non-Premier, 0.82).

conclusionsOur results show no evidence of a deleterious effect of P4P on access to coronary artery bypass graft surgery for high-risk patients with AMI. These results should be reassuring to those concerned about the potential negative effect of P4P on high-risk patients.

Indexed as

Coronary Artery BypassAcute DiseaseAgedAged, 80 and overFemaleHealth Services AccessibilityHumansMaleMedicareMyocardial InfarctionQuality of Health CareReimbursement, IncentiveRisk AdjustmentUnited Statescoronary artery bypass graftingpay for performance

Identifiers

PMID25160840
PMCPMC4279704
OpenAlexW2109433958

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.