Evidence map›Paper›PMID 28830291›Full record

Observational studyScandinavian journal of primary health care2017

Pay for performance associated with increased volume of medication reviews but not with less inappropriate use of medications among the elderly - an observational study.

H Ödesjö, A Anell, A Boman, J Fastbom, S Franzén, J Thorn, S Björck

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scandinavian journal of primary health care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.4field-weighted citation impact, top 7% 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

9 citing papers in PubMed, 14 citations in OpenAlex.

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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

7 authors at 5 institutions in 1 country.

H Ödesjöa Department of Public Health and Community Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Primary Health Care, Region Västra Götaland , Gothenburg , Sweden.
A Anellb Lund University School of Economics and Management , Lund , Sweden.
A Bomanc Department of Economics, School of Business, Economics and Law , University of Gothenburg , Gothenburg , Sweden.
J Fastbomd Aging Research Centre, Karolinska Institutet and Stockholm University , Stockholm , Sweden.
S Franzéne Centre of Registers, Region Västra Götaland , Gothenburg , Sweden.
J Thorna Department of Public Health and Community Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Primary Health Care, Region Västra Götaland , Gothenburg , Sweden.
S Björcke Centre of Registers, Region Västra Götaland , Gothenburg , Sweden.
Region Västra Götaland · SEUniversity of Gothenburg · SECentre of Registers Vastra Gotaland · SELund University · SEStockholm University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveA pay for performance programme was introduced in 2009 by a Swedish county with 1.6 million inhabitants. A process measure with payment linked to coding for medication reviews among the elderly was adopted. We assessed the association with inappropriate medication for five years after baseline. DESIGN AND

settingObservational study that compared medication for elderly patients enrolled at primary care units that coded for a high or low volume of medication reviews. PATIENTS: 144,222 individuals at 196 primary care centres, age 75 or older.

main outcome measuresPercentage of patients receiving inappropriate drugs or polypharmacy during five years at primary care units with various levels of reported medication reviews.

resultsThe proportion of patients with a registered medication review had increased from 3.2% to 44.1% after five years. The high-coding units performed better for most indicators but had already done so at baseline. Primary care units with the lowest payment for coding for medication reviews improved just as well in terms of inappropriate drugs as units with the highest payment - from 13.0 to 8.5%, compared to 11.6 to 7.4% and from 13.6 to 7.2% vs 11.8 to 6.5% for polypharmacy.

conclusionsPayment linked to coding for medication reviews was associated with an increase in the percentage of patients for whom a medication review had been registered. However, the impact of payment on quality improvement is uncertain, given that units with the lowest payment for medication reviews improved equally well as units with the highest payment.

Indexed as

Inappropriate PrescribingPolypharmacyPrimary Health CareReimbursement, IncentiveAgedAged, 80 and overFemaleHumansMaleSwedenelderlyhealth care quality assessmentpay for performancepotentially inappropriate medication listPrimary health carequality indicatorsSweden

Identifiers

PMID28830291
PMCPMC5592354
OpenAlexW2745824053

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.