Pay-for-performance as a cost-effective implementation strategy: results from a cluster randomized trial.

Abstract:

BACKGROUND:Pay-for-performance (P4P) has been recommended as a promising strategy to improve implementation of high-quality care. This study examined the incremental cost-effectiveness of a P4P strategy found to be highly effective in improving the implementation and effectiveness of the Adolescent Community Reinforcement Approach (A-CRA), an evidence-based treatment (EBT) for adolescent substance use disorders (SUDs). METHODS:Building on a $30 million national initiative to implement A-CRA in SUD treatment settings, urn randomization was used to assign 29 organizations and their 105 therapists and 1173 patients to one of two conditions (implementation-as-usual (IAU) control condition or IAU+P4P experimental condition). It was not possible to blind organizations, therapists, or all research staff to condition assignment. All treatment organizations and their therapists received a multifaceted implementation strategy. In addition to those IAU strategies, therapists in the IAU+P4P condition received US $50 for each month that they demonstrated competence in treatment delivery (A-CRA competence) and US $200 for each patient who received a specified number of treatment procedures and sessions found to be associated with significantly improved patient outcomes (target A-CRA). Incremental cost-effectiveness ratios (ICERs), which represent the difference between the two conditions in average cost per treatment organization divided by the corresponding average difference in effectiveness per organization, and quality-adjusted life years (QALYs) were the primary outcomes. RESULTS:At trial completion, 15 organizations were randomized to the IAU condition and 14 organizations were randomized to the IAU+P4P condition. Data from all 29 organizations were analyzed. Cluster-level analyses suggested the P4P strategy led to significantly higher average total costs compared to the IAU control condition, yet this average increase of 5% resulted in a 116% increase in the average number of months therapists demonstrated competence in treatment delivery (ICER = $333), a 325% increase in the average number of patients who received the targeted dosage of treatment (ICER = $453), and a 325% increase in the number of days of abstinence per patient in treatment (ICER = $8.134). Further supporting P4P as a cost-effective implementation strategy, the cost per QALY was only $8681 (95% confidence interval $1191-$16,171). CONCLUSION:This study provides experimental evidence supporting P4P as a cost-effective implementation strategy. TRIAL REGISTRATION:NCT01016704 .

journal_name

Implement Sci

authors

Garner BR,Lwin AK,Strickler GK,Hunter BD,Shepard DS

doi

10.1186/s13012-018-0774-1

subject

Has Abstract

pub_date

2018-07-04 00:00:00

pages

92

issue

1

issn

1748-5908

pii

10.1186/s13012-018-0774-1

journal_volume

13

pub_type

杂志文章,随机对照试验
  • Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.

    abstract:BACKGROUND:This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Pe...

    journal_title:Implementation science : IS

    pub_type: 杂志文章,评审

    doi:10.1186/s13012-017-0553-4

    authors: Band R,Bradbury K,Morton K,May C,Michie S,Mair FS,Murray E,McManus RJ,Little P,Yardley L

    更新日期:2017-02-23 00:00:00

  • Implementation of case management to reduce cardiovascular disease risk in the Stanford and San Mateo Heart to Heart randomized controlled trial: study protocol and baseline characteristics.

    abstract:BACKGROUND:Case management has emerged as a promising alternative approach to supplement traditional one-on-one sessions between patients and doctors for improving the quality of care in chronic diseases such as coronary heart disease (CHD). However, data are lacking in terms of its efficacy and cost-effectiveness when...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-1-21

    authors: Ma J,Lee KV,Berra K,Stafford RS

    更新日期:2006-09-27 00:00:00

  • Implementation facilitation to promote emergency department-initiated buprenorphine for opioid use disorder: protocol for a hybrid type III effectiveness-implementation study (Project ED HEALTH).

    abstract:BACKGROUND:Patients with opioid use disorder (OUD) frequently present to the emergency department (ED) after overdose, or seeking treatment for general medical conditions, their addiction, withdrawal symptoms, or complications of injection drug use, such as soft tissue infections. ED-initiated buprenorphine has been sh...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-019-0891-5

    authors: D'Onofrio G,Edelman EJ,Hawk KF,Pantalon MV,Chawarski MC,Owens PH,Martel SH,VanVeldhuisen P,Oden N,Murphy SM,Huntley K,O'Connor PG,Fiellin DA

    更新日期:2019-05-07 00:00:00

  • From recommendation to action: psychosocial factors influencing physician intention to use Health Technology Assessment (HTA) recommendations.

    abstract:BACKGROUND:Evaluating the impact of recommendations based upon health technology assessment (HTA) represents a challenge for both HTA agencies and healthcare policy-makers. Using a psychosocial theoretical framework, this study aimed at exploring the factors affecting physician intention to adopt HTA recommendations. T...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-1-8

    authors: Gagnon MP,Sánchez E,Pons JM

    更新日期:2006-03-31 00:00:00

  • Disentangling rhetoric and reality: an international Delphi study of factors and processes that facilitate the successful implementation of decisions to decommission healthcare services.

    abstract:BACKGROUND:The need to better understand processes of removing, reducing, or replacing healthcare services that are no longer deemed essential or effective is common across publicly funded healthcare systems. This paper explores expert international opinion regarding, first, the factors and processes that shape the suc...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-014-0123-y

    authors: Robert G,Harlock J,Williams I

    更新日期:2014-09-10 00:00:00

  • Understanding the uptake of a clinical innovation for osteoarthritis in primary care: a qualitative study of knowledge mobilisation using the i-PARIHS framework.

    abstract:BACKGROUND:Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective,...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-020-01055-2

    authors: Swaithes L,Dziedzic K,Finney A,Cottrell E,Jinks C,Mallen C,Currie G,Paskins Z

    更新日期:2020-10-28 00:00:00

  • When is good, good enough? Methodological pragmatism for sustainable guideline development.

    abstract:BACKGROUND:Continuous escalation in methodological and procedural rigor for evidence-based processes in guideline development is associated with increasing costs and production delays that threaten sustainability. While health research methodologists are appropriately responsible for promoting increasing rigor in guide...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-015-0222-4

    authors: Browman GP,Somerfield MR,Lyman GH,Brouwers MC

    更新日期:2015-03-06 00:00:00

  • Adjust your own oxygen mask before helping those around you: an autoethnography of participatory research.

    abstract:BACKGROUND:There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address rese...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-020-01002-1

    authors: Steketee AM,Archibald TG,Harden SM

    更新日期:2020-09-03 00:00:00

  • Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: a randomised controlled trial.

    abstract:BACKGROUND:This study examined the effectiveness of seven different interventions designed to increase the proportion of general practitioners (GPs) accepting an offer of free access to an online evidence-based resource. METHODS:Australian GPs (n = 14,000) were randomly selected and assigned to seven intervention grou...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-4-68

    authors: Buchan H,Lourey E,D'Este C,Sanson-Fisher R

    更新日期:2009-10-20 00:00:00

  • Measuring persistence of implementation: QUERI Series.

    abstract::As more quality improvement programs are implemented to achieve gains in performance, the need to evaluate their lasting effects has become increasingly evident. However, such long-term follow-up evaluations are scarce in healthcare implementation science, being largely relegated to the "need for further research" sec...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-3-21

    authors: Bowman CC,Sobo EJ,Asch SM,Gifford AL,HIV\/Hepatitis Quality Enhancement Research Initiative.

    更新日期:2008-04-22 00:00:00

  • Making sense of health information technology implementation: A qualitative study protocol.

    abstract:BACKGROUND:Implementing new practices, such as health information technology (HIT), is often difficult due to the disruption of the highly coordinated, interdependent processes (e.g., information exchange, communication, relationships) of providing care in hospitals. Thus, HIT implementation may occur slowly as staff m...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-5-95

    authors: Kitzmiller RR,Anderson RA,McDaniel RR Jr

    更新日期:2010-11-29 00:00:00

  • An implementation research agenda.

    abstract::In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to a...

    journal_title:Implementation science : IS

    pub_type: 社论

    doi:10.1186/1748-5908-4-18

    authors: Eccles MP,Armstrong D,Baker R,Cleary K,Davies H,Davies S,Glasziou P,Ilott I,Kinmonth AL,Leng G,Logan S,Marteau T,Michie S,Rogers H,Rycroft-Malone J,Sibbald B

    更新日期:2009-04-07 00:00:00

  • Effectiveness of a multi-level implementation strategy for ASD interventions: study protocol for two linked cluster randomized trials.

    abstract:BACKGROUND:The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on general...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-018-0757-2

    authors: Brookman-Frazee L,Stahmer AC

    更新日期:2018-05-09 00:00:00

  • The uptake and effect of a mailed multi-modal colon cancer screening intervention: a pilot controlled trial.

    abstract:BACKGROUND:We sought to determine whether a multi-modal intervention, which included mailing a patient reminder with a colon cancer decision aid to patients and system changes allowing direct access to scheduling screening tests through standing orders, would be an effective and efficient means of promoting colon cance...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-3-32

    authors: Lewis CL,Brenner AT,Griffith JM,Pignone MP

    更新日期:2008-06-02 00:00:00

  • GRAIDs: a framework for closing the gap in the availability of health promotion programs and interventions for people with disabilities.

    abstract:BACKGROUND:Evidence-based health promotion programs developed and tested in the general population typically exclude people with disabilities. To address this gap, a set of methods and criteria were created to adapt evidence-based health promotion programs for people with disabilities. In this first study, we describe ...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-014-0100-5

    authors: Rimmer JH,Vanderbom KA,Bandini LG,Drum CE,Luken K,Suarez-Balcazar Y,Graham ID

    更新日期:2014-08-14 00:00:00

  • Evidence-informed health policy 4 - case descriptions of organizations that support the use of research evidence.

    abstract:BACKGROUND:Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case ...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-3-56

    authors: Lavis JN,Moynihan R,Oxman AD,Paulsen EJ

    更新日期:2008-12-17 00:00:00

  • Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance.

    abstract:BACKGROUND:Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of inter...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-019-0956-5

    authors: Movsisyan A,Arnold L,Evans R,Hallingberg B,Moore G,O'Cathain A,Pfadenhauer LM,Segrott J,Rehfuess E

    更新日期:2019-12-17 00:00:00

  • Implementation capital: merging frameworks of implementation outcomes and social capital to support the use of evidence-based practices.

    abstract:BACKGROUND:Although there is growing recognition that the implementation of evidence-based practices is a social process, the conceptualization of social capital in implementation frameworks often conflates bonding and bridging social capital. This conflation makes it difficult to concretely operationalize social capit...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-019-0860-z

    authors: Neal JW,Neal ZP

    更新日期:2019-02-14 00:00:00

  • Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes.

    abstract:BACKGROUND:Translation of evidence-based interventions into hospital systems can provide immediate and substantial benefits to patient care and outcomes, but successful implementation is often not achieved. Existing literature describes a range of barriers and facilitators to the implementation process. This systematic...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-018-0726-9

    authors: Geerligs L,Rankin NM,Shepherd HL,Butow P

    更新日期:2018-02-23 00:00:00

  • Priority setting for the implementation of artemisinin-based combination therapy policy in Tanzania: evaluation against the accountability for reasonableness framework.

    abstract:BACKGROUND:Priority setting for artemisinin-based antimalarial drugs has become an integral part of malaria treatment policy change in malaria-endemic countries. Although these drugs are more efficacious, they are also more costly than the failing drugs. When Tanzania changed its National Malaria Treatment Policy in 20...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-7-18

    authors: Mori AT,Kaale EA

    更新日期:2012-03-18 00:00:00

  • Effectiveness of multifaceted implementation strategies for the implementation of back and neck pain guidelines in health care: a systematic review.

    abstract:BACKGROUND:For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no implementation strategy for t...

    journal_title:Implementation science : IS

    pub_type: 杂志文章,评审

    doi:10.1186/s13012-016-0482-7

    authors: Suman A,Dikkers MF,Schaafsma FG,van Tulder MW,Anema JR

    更新日期:2016-09-20 00:00:00

  • Evaluation of an interactive program for preventing adverse drug events in primary care: study protocol of the InPAct cluster randomised stepped wedge trial.

    abstract:BACKGROUND:Adverse drug events could often be prevented. One of their main causes is that patients rarely know how to detect them. Another cause is inadequate communication between patients and physicians. If patients were to be effectively trained in detecting and reporting adverse drug events, this should help to pre...

    journal_title:Implementation science : IS

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1748-5908-8-69

    authors: Keriel-Gascou M,Buchet-Poyau K,Duclos A,Rabilloud M,Figon S,Dubois JP,Brami J,Vial T,Colin C

    更新日期:2013-06-19 00:00:00

  • Implementation of a patient decision aid for men with localized prostate cancer: evaluation of patient outcomes and practice variation.

    abstract:BACKGROUND:Men with localized prostate cancer often have unrealistic expectations. Practitioners are poor judges of men's preferences, contributing to preference misdiagnosis and unwarranted practice variation. Patient decision aids (PtDAs) can support men with decisions about localized prostate cancer. This is a compa...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-016-0451-1

    authors: Stacey D,Taljaard M,Smylie J,Boland L,Breau RH,Carley M,Jana K,Peckford L,Blackmore T,Waldie M,Wu RC,Legare F

    更新日期:2016-07-02 00:00:00

  • Bridging the knowledge-practice gap in tuberculosis contact management in a high-burden setting: a mixed-methods protocol for a multicenter health system strengthening study.

    abstract:BACKGROUND:People in close contact with tuberculosis should have screening and appropriate management, as an opportunity for active case detection and prevention. However, implementation of tuberculosis contact screening and management is limited in high-burden settings. Behaviour change is needed across three levels o...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-019-0870-x

    authors: Lestari T,Graham S,van den Boogard C,Triasih R,Poespoprodjo JR,Ubra RR,Kenangalem E,Mahendradhata Y,Anstey NM,Bailie RS,Ralph AP

    更新日期:2019-03-19 00:00:00

  • Development and verification of an agent-based model of opinion leadership.

    abstract:BACKGROUND:The use of opinion leaders is a strategy used to speed the process of translating research into practice. Much is still unknown about opinion leader attributes and activities and the context in which they are most effective. Agent-based modeling is a methodological tool that enables demonstration of the inte...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/s13012-014-0136-6

    authors: Anderson CA,Titler MG

    更新日期:2014-09-27 00:00:00

  • A pragmatic study exploring the prevention of delirium among hospitalized older hip fracture patients: Applying evidence to routine clinical practice using clinical decision support.

    abstract:: Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of ...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-5-81

    authors: Holroyd-Leduc JM,Abelseth GA,Khandwala F,Silvius JL,Hogan DB,Schmaltz HN,Frank CB,Straus SE

    更新日期:2010-10-22 00:00:00

  • Barriers and enablers to delivery of the Healthy Kids Check: an analysis informed by the Theoretical Domains Framework and COM-B model.

    abstract:BACKGROUND:More than a fifth of Australian children arrive at school developmentally vulnerable. To counteract this, the Healthy Kids Check (HKC), a one-off health assessment aimed at preschool children, was introduced in 2008 into Australian general practice. Delivery of services has, however, remained low. The Theore...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-9-60

    authors: Alexander KE,Brijnath B,Mazza D

    更新日期:2014-05-23 00:00:00

  • Scale up of PrEP integrated in public health HIV care clinics: a protocol for a stepped-wedge cluster-randomized rollout in Kenya.

    abstract:BACKGROUND:Antiretroviral therapy (ART) for HIV-infected persons and pre-exposure prophylaxis (PrEP) for uninfected persons are extraordinarily effective strategies for HIV prevention. In Africa, the region which shoulders the highest HIV burden, HIV care is principally delivered through public health HIV care clinics,...

    journal_title:Implementation science : IS

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s13012-018-0809-7

    authors: Mugwanya KK,Irungu E,Bukusi E,Mugo NR,Odoyo J,Wamoni E,Ngure K,Morton JF,Peebles K,Masyuko S,Barnabee G,Donnell D,Barnabas R,Haberer J,O'Malley G,Baeten JM,Partners Scale Up Team.

    更新日期:2018-09-04 00:00:00

  • How can continuing professional development better promote shared decision-making? Perspectives from an international collaboration.

    abstract:BACKGROUND:Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. METHODS:Thirty-six participants met for two days. RESULTS:Participants suggested ways to improve an environmental scan that h...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-6-68

    authors: Légaré F,Bekker H,Desroches S,Drolet R,Politi MC,Stacey D,Borduas F,Cheater FM,Cornuz J,Coutu MF,Ferdjaoui-Moumjid N,Griffiths F,Härter M,Jacques A,Krones T,Labrecque M,Neely C,Rodriguez C,Sargeant J,Schuerman JS,

    更新日期:2011-07-05 00:00:00

  • Why a successful task substitution in glaucoma care could not be transferred from a hospital setting to a primary care setting: a qualitative study.

    abstract:BACKGROUND:Healthcare systems are challenged by a demand that exceeds available resources. One policy to meet this challenge is task substitution-transferring tasks to other professions and settings. Our study aimed to explore stakeholders' perceived feasibility of transferring hospital-based monitoring of stable glauc...

    journal_title:Implementation science : IS

    pub_type: 杂志文章

    doi:10.1186/1748-5908-8-14

    authors: Holtzer-Goor KM,Plochg T,Lemij HG,van Sprundel E,Koopmanschap MA,Klazinga NS

    更新日期:2013-01-25 00:00:00