Randomized Controlled Cluster Trial of Resident Pay for Performance and Cardiovascular Outcomes

Heart Failure Clinical Trial

Official title:

Randomized Controlled Cluster Trial of Resident Pay for Performance and Cardiovascular Outcomes

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT01590290
• Other study ID #: 16033
• Status: Recruiting
• Phase: Phase 3
• First received: April 30, 2012
• Last updated: May 1, 2012
• Start date: April 2012

Study information

• Verified date: April 2012
• Source: University of Virginia
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine if a pay for performance model in contrast to the traditional "fee for service" model may improve the number of patients discharged being treated in accordance with Joint Commission on Health Care JCAHO (a non-for profit organization that accredits health care organizations) standards and standard of care for management of hyperlipidemia

In this study the investigators will evaluate these two models by training resident physicians (doctors in training) on JCAHO core measures and specific criteria related to accepted standard of care for acute myocardial infarction and heart failure. The physicians will be randomized to a pay for performance or a fee for service model. Then a medical record review will be performed on patient records that received a discharge diagnosis of myocardial infarction or heart failure and were cared for by the physician subjects

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 38
• Est. primary completion date: April 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Physician inclusion: Resident physician on the Acute Cardiology Service, the Coronary Care Unit, or the General Medicine Service at the University of Virginia

• Patient inclusion: discharge diagnosis of heart failure or myocardial infarction.

Exclusion Criteria:

• Residents that are part of the study team

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Heart Failure
• Myocardial Infarction

Intervention

Other:
• financial compensation
financial monetary reimbursement

Locations

Country	Name	City	State
United States	University of Virginia	Charlottesville	Virginia

Sponsors (1)

Lead Sponsor	Collaborator
University of Virginia

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	compliance with composite pay for performance measure	In patients discharged from the Coronary Care Unit, Acute Coronary Care Service, or General Medical Service with the discharge diagnosis of either heart failure or myocardial infarction, there is no difference in the rate of compliance with the composite score (see below; Heart Failure Score or Myocardial Infarction Score) between physicians reimbursed in a pay for performance scheme and those who receive no additional reimbursement.	1 month	No
Secondary	heart failure composite score	In patients discharged from the Coronary Care Unit, Acute Coronary Care Service, or General Medical Service with the discharge diagnosis of heart failure there is no difference between rate of compliance with Heart Failure Score between physicians reimbursed in a pay for performance scheme and those who receive no additional reimbursement.	1 month	No
Secondary	myocardial infarction score	In patients discharged from the Coronary Care Unit, Acute Coronary Care Service, or General Medical Service with the discharge diagnosis of myocardial infarction there is no difference between the rate of compliance with Myocardial Infarction Score between physicians reimbursed in a pay for performance scheme and those who receive no additional reimbursement.	1 month	No
Secondary	readmission rate	In patients discharged from the Coronary Care Unit, Acute Coronary Care Service, or General Medical Service with the discharge diagnosis heart failure there is no difference between 30-day readmission rate between patients that had an appointment less than 7 days and those that did not.	30 days	No