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Pay-for-performance may benefit doctors who care for very sick
Date:6/1/2009

and kidneys.

In their study, the researchers identified 141,609 patients with high blood pressure in a VA database. Of these 22,595 had no other serious health conditions; 70,098 had conditions that could be related to the high blood pressure (concordant), 12,283 other health conditions not related to high blood pressure (discordant) and 36,633 had both.

Blood pressure was controlled for 12,956 (57.3 percent) of patients with no other health conditions, 45,334 (64.7 percent) of those with concordant or related health conditions and 7,742 (63 percent) of those with other conditions not related to blood pressure. Of those with both concordant and discordant condition, 25,339 or 69.2 percent had blood pressure controlled.

The researchers noted that quality of care increased with the number of other conditions the patient had. In other words, the sicker the patient, the better the care, even after statistically controlling for the numbers of visits with a doctor.

"Our results should be reassuring for policy-makers who have faced crticism that performance measures, public reporting, and pay-for-performance initiatives may penalize health care providers of patients with multiple co-existing chronic conditions," they wrote.


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Contact: Gracie Gutierrez
ggutierr@bcm.edu
713-798-4710
Baylor College of Medicine
Source:Eurekalert

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