Evidence map›Paper›PMID 32813687›Full record

ArticlePloS one2020

Effects of quality-based procedure hospital funding reform in Ontario, Canada: An interrupted time series study.

Alvin Ho-Ting Li, Karen S Palmer, Monica Taljaard, J Michael Paterson, Adalsteinn Brown, Anjie Huang, Husayn Marani, Lauren Lapointe-Shaw, Daniel Pincus, Marian S Wettstein and 3 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 11% 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

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. The impact of the Ontario quality-based procedures funding model on radical prostatectomy outcomes.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024
    Article
  2. Enhancing care for hip fracture patients through a Quality-Based Procedures funding model.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024
    Article
  3. Article
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

13 authors at 7 institutions in 1 country.

Alvin Ho-Ting LiOttawa Hospital Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0003-0508-6109
Karen S PalmerWomen's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Monica TaljaardOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
J Michael PatersonInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Adalsteinn BrownInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Anjie HuangInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Husayn MaraniWomen's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Lauren Lapointe-ShawDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Daniel PincusInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Marian S WettsteinInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Girish S KulkarniInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
David WassersteinDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Noah IversInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
University of Toronto · CAUniversity Health Network · CAInstitute for Clinical Evaluative Sciences · CAOttawa Hospital · CASimon Fraser University · CASunnybrook Health Science Centre · CAUniversity of Ottawa · CA

Funding

CIHR
6 · The paper itself

Abstract

backgroundThe Government of Ontario, Canada, announced hospital funding reforms in 2011, including Quality-based Procedures (QBPs) involving pre-set funds for managing patients with specific diagnoses/procedures. A key goal was to improve quality of care across the jurisdiction.

methodsInterrupted time series evaluated the policy change, focusing on four QBPs (congestive heart failure, hip fracture surgery, pneumonia, prostate cancer surgery), on patients hospitalized 2010-2017. Outcomes included return to hospital or death within 30 days, acute length of stay (LOS), volume of admissions, and patient characteristics.

resultsAt 2 years post-QBPs, the percentage of hip fracture patients who returned to hospital or died was 3.13% higher in absolute terms (95% CI: 0.37% to 5.89%) than if QBPs had not been introduced. There were no other statistically significant changes for return to hospital or death. For LOS, the only statistically significant change was an increase for prostate cancer surgery of 0.33 days (95% CI: 0.07 to 0.59). Volume increased for congestive heart failure admissions by 80 patients (95% CI: 2 to 159) and decreased for hip fracture surgery by 138 patients (95% CI: -183 to -93) but did not change for pneumonia or prostate cancer surgery. The percentage of patients who lived in the lowest neighborhood income quintile increased slightly for those diagnosed with congestive heart failure (1.89%; 95% CI: 0.51% to 3.27%) and decreased for those who underwent prostate cancer surgery (-2.08%; 95% CI: -3.74% to -0.43%).

interpretationThis policy initiative involving a change to hospital funding for certain conditions was not associated with substantial, jurisdictional-level changes in access or quality.

Indexed as

HospitalsAdultAgedAged, 80 and overEconomics, HospitalFemaleFinancial ManagementHeart FailureHip FracturesHospitalizationHumansInterrupted Time Series AnalysisLength of StayMaleMiddle AgedOntario

Identifiers

PMID32813687
PMCPMC7437861
OpenAlexW3058340837

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.