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Pay-for-performance reduces health care spending and improves quality of care in Korea: Analysis of target and non-target obstetrics and gynecology surgeries (2011-2014)

Authors
 Seung Ju Kim  ;  Kyu-Tae Han  ;  Sun Jung Kim  ;  Eun-Cheol Park 
Citation
 INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, Vol.29(2) : 222-227, 2017 
Journal Title
 INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE 
ISSN
 1353-4505 
Issue Date
2017
Keywords
quality improvement ; quality indicators ; patient outcomes ; health policy ; readmission
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 condition-specific 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 non-target 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.
Files in This Item:
T201701526.pdf Download
DOI
10.1093/intqhc/mzw159
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154370
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