In an effort to address emergency department overcrowding, pay-for-performance (P4P) incentive programs have been implemented in various regions around the world, including hospitals in Metro Vancouver. But a new study from the UBC Sauder School of Business shows that while such programs can reduce barriers to access for admitted patients, they can also lead to patient discharges associated with return visits and readmissions.
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“Our recommendations based on this research are that setting an incentive for admitted patients improves length of stay, but the four-hour benchmark for discharged patients should be implemented with care,” said Dr. Garth Hunte, study co-author and emergency physician at St. Paul Hospital in Vancouver. “There is no sense for an incentive to discharge patients that may require admission to hospital.” This is consistent with what the hospitals are actually now doing, thanks to the regional health authorities’ ongoing funding of the admission incentive.
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