Do Financial Incentives Change Length‐of‐stay Performance in Emergency Departments? A Retrospective Study of the Pay‐for‐performance Program in Metro Vancouver

• DOI: 10.1111/acem.13635
• Publication Date: 2019-07-18T08:01:06Z
• Authors: Yuren Wang; Yichuan Ding; Eric Park; Garth Hunte
• Keywords: Pay for Performance

Abstract Background Pay‐for‐performance (P4P) programs have been implemented in various forms to reduce emergency department ( ED ) patient length of stay LOS ). This retrospective study investigated what extent the timing disposition Metro Vancouver s was influenced by a ‐based P4P program. Methods We analyzed visit records four major hospitals Vancouver, Canada. For each , we individually tested whether distributed discontinuously at target before and after program terminated. effective period, examined patients discharged just prior had higher 7‐day return‐and‐admission RA rate—the probability that patient, being home, returned any within 7 days admitted an inpatient unit—than target. Results Prior termination program, all s, density discontinuous significant drop 10‐hours admission target; similar phenomenon observed among 4‐hours discharge target, but only two lower‐volume s. Furthermore, who were right rate than After incentive, discontinuity became less evident, still more frequently 10 hours three as local health authority continued support incentive scheme government terminated Conclusions The financial appears dispositions. results suggest mixed consequences program—it can access block for may also lead discharges associated with return visits admissions.