Volume 197 - Issue 10
Designing incentives for good-quality hospital care
Author: Stephen J Duckett
Med J Aust 2012; 197 (10): 554. || doi: 10.5694/mja12.11264
Published online: 19 November 2012
Published online: 19 November 2012
In reply: Evans and colleagues present their critique of my proposition1 to use incentives based on adverse events recorded in routine data as an alternative - it is not. Routine data, audits and registries all have a place in the quest to improve safety of care in hospitals.
The financial impact of non-pay
for non-performance may be small. However, early evidence from the United States suggests ...
In reply: Evans and colleagues present their critique of my proposition1 to use incentives based on adverse events recorded in routine data as an alternative — it is not. Routine data, audits and registries all have a place in the quest to improve safety of care in hospitals.
The financial impact of non-pay for non-performance may be small. However, early evidence from the United States suggests that either the payments or the associated reputational risk is enough to attract management attention and create a “business case” for quality and/or documentation improvement.2,3
Although Evans and colleagues refer to my suggestion as using “administrative data [collected for] funding purposes”, it is important to remember that routine data are collected for multiple purposes, not just administrative, and the collections were in place long before they were used for funding. The data themselves are not “administrative”. The data in these collections are abstracted by professional coders from what clinicians have recorded in patient records.
Competing interests
No relevant disclosures.
References
- Duckett SJ. Designing incentives for good-quality hospital care. Med J Aust 2012; 196: 678-679. 0_CHDCGIGH
- Lee GM, Hartmann CW, et al. Perceived impact of the Medicare policy to adjust payment for health care-associated infections. Am J Infect Control 2012; 40: 314-319. 0_i1142861
- McHugh MK, Van Dyke, et al. Medicare’s payment policy for hospital-acquired conditions. Med Care Res Rev 2011; 68: 667-682. 0_i1142863