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Pay-for-Performance i svensk primärvård- effektiv ersättningsmodell eller slöseri med resurser?

Enhörning Admarker, Thea LU (2018) NEKN01 20181
Department of Economics
Abstract (Swedish)
Denna studie undersöker om införandet av Pay-for-Performance-program (P4P) i Sveriges primärvård har påverkat antal undvikbara slutenvårdstillfällen. I Västernorrland och Västerbotten har man använt sig av P4P med kvalitetsindikatorn undvikbar slutenvård under åren 2012-2014. Dessa län definieras som behandlingsgrupp i studien, och resterande län definieras som kontrollgrupp. Studien genomförs med en Difference-in-Difference-metod (DID) för att undersöka om behandlingsgruppen skiljer sig från kontrollgruppen i antal undvikbara slutenvårdstillfällen för åren då P4P använts. Resultaten från studien visar på att P4P har haft signifikanta och relativt stora effekter på undvikbar slutenvård. Ett nationellt mål att minska antalet undvikbara... (More)
Denna studie undersöker om införandet av Pay-for-Performance-program (P4P) i Sveriges primärvård har påverkat antal undvikbara slutenvårdstillfällen. I Västernorrland och Västerbotten har man använt sig av P4P med kvalitetsindikatorn undvikbar slutenvård under åren 2012-2014. Dessa län definieras som behandlingsgrupp i studien, och resterande län definieras som kontrollgrupp. Studien genomförs med en Difference-in-Difference-metod (DID) för att undersöka om behandlingsgruppen skiljer sig från kontrollgruppen i antal undvikbara slutenvårdstillfällen för åren då P4P använts. Resultaten från studien visar på att P4P har haft signifikanta och relativt stora effekter på undvikbar slutenvård. Ett nationellt mål att minska antalet undvikbara slutenvårdstillfällen med 10 % sattes 2012, och resultaten från studien visar på att målet uppfyllts och nära nog uppfylls beroende på vad som inkluderas i regressionerna, som en effekt av införandet av P4P. Till skillnad från tidigare forskning så kan denna studie visa på relativt stora effekter, en generell effekt relativ till medelvärde på -14,6 % undvikbara slutenvårdstillfällen av införandet av P4P. Effekten visar sig vara störst för de äldsta åldersgrupperna i samhället. Den största effekten av P4P verkar också kunna isoleras till Västerbotten, vilket skulle kunna vara ett bevis på att Västerbottens P4P hade en bättre design än Västernorrlands. (Less)
Abstract
This study examines if the implementation of Pay-for-Performance-programmes (P4P) in Swedish primary care has had an effect on avoidable hospitalizations. In the counties Västernorrland and Västerbotten P4P has been used with the quality indicator avoidable hospitalization included in the programme during 2012-2014. These counties are defined as the treatment group in the study, and the remaining counties in Sweden are defined as the control group. The study will be executed with a Difference-in-Difference-method (DID) to examine if the treatment group is significantly different from the control group in terms of the number of avoidable hospitalizations during the years when P4P was used. The results of the study show that P4P has had... (More)
This study examines if the implementation of Pay-for-Performance-programmes (P4P) in Swedish primary care has had an effect on avoidable hospitalizations. In the counties Västernorrland and Västerbotten P4P has been used with the quality indicator avoidable hospitalization included in the programme during 2012-2014. These counties are defined as the treatment group in the study, and the remaining counties in Sweden are defined as the control group. The study will be executed with a Difference-in-Difference-method (DID) to examine if the treatment group is significantly different from the control group in terms of the number of avoidable hospitalizations during the years when P4P was used. The results of the study show that P4P has had significant and relatively large effects on the number of avoidable hospitalizations. A national target to decrease avoidable hospitalizations by 10 % was implemented in 2012, and the results of the study show that this target has been reached, or nearly reached, depending on what is included in the regressions, as an effect of the implementation of P4P. Unlike past empirical research, this study can show relatively large effects of the implementation of P4P, a general effect relative to the mean of -14,6 % avoidable hospitalizations. The effect is mainly driven by the oldest age groups in society. The biggest effect of P4P can also be isolated to Västerbotten, which could indicate that the P4P-programme in Västerbotten had a better design than the one in Västernorrland. (Less)
Please use this url to cite or link to this publication:
author
Enhörning Admarker, Thea LU
supervisor
organization
course
NEKN01 20181
year
type
H1 - Master's Degree (One Year)
subject
keywords
Pay-for-Performance, P4P, Sjukvård, Primärvård, Undvikbara Slutenvårdstillfällen, Prestationsersättning, Målersättning, Health care, Primary care, Avoidable Hospitalizations, Performance, Value-Based Purchasing
language
Swedish
id
8949055
date added to LUP
2018-07-03 14:20:30
date last changed
2018-07-03 14:20:30
@misc{8949055,
  abstract     = {This study examines if the implementation of Pay-for-Performance-programmes (P4P) in Swedish primary care has had an effect on avoidable hospitalizations. In the counties Västernorrland and Västerbotten P4P has been used with the quality indicator avoidable hospitalization included in the programme during 2012-2014. These counties are defined as the treatment group in the study, and the remaining counties in Sweden are defined as the control group. The study will be executed with a Difference-in-Difference-method (DID) to examine if the treatment group is significantly different from the control group in terms of the number of avoidable hospitalizations during the years when P4P was used. The results of the study show that P4P has had significant and relatively large effects on the number of avoidable hospitalizations. A national target to decrease avoidable hospitalizations by 10 % was implemented in 2012, and the results of the study show that this target has been reached, or nearly reached, depending on what is included in the regressions, as an effect of the implementation of P4P. Unlike past empirical research, this study can show relatively large effects of the implementation of P4P, a general effect relative to the mean of -14,6 % avoidable hospitalizations. The effect is mainly driven by the oldest age groups in society. The biggest effect of P4P can also be isolated to Västerbotten, which could indicate that the P4P-programme in Västerbotten had a better design than the one in Västernorrland.},
  author       = {Enhörning Admarker, Thea},
  keyword      = {Pay-for-Performance,P4P,Sjukvård,Primärvård,Undvikbara Slutenvårdstillfällen,Prestationsersättning,Målersättning,Health care,Primary care,Avoidable Hospitalizations,Performance,Value-Based Purchasing},
  language     = {swe},
  note         = {Student Paper},
  title        = {Pay-for-Performance i svensk primärvård- effektiv ersättningsmodell eller slöseri med resurser?},
  year         = {2018},
}