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dc.contributor.authorMcLeod, H.*
dc.contributor.authorBlissett, D.*
dc.contributor.authorWyatt, S.*
dc.contributor.authorMohammed, Mohammed A.*
dc.date.accessioned2016-09-21T16:51:54Z
dc.date.available2016-09-21T16:51:54Z
dc.date.issued2015-04-15
dc.identifier.citationMcLeod H, Blissett D, Wyatt S et al (2015) Effect of pay-for-outcomes and encouraging new providers on national health service smoking cessation services in England: a cluster controlled study. PLoS One. 10(4), e0123349.
dc.identifier.urihttp://hdl.handle.net/10454/9266
dc.descriptionYes
dc.description.abstractPayment incentives are known to influence healthcare but little is known about the impact of paying directly for achieved outcomes. In England, novel purchasing (commissioning) of National Health Service (NHS) stop smoking services, which paid providers for quits achieved whilst encouraging new market entrants, was implemented in eight localities (primary care trusts (PCTs)) in April 2010. This study examines the impact of the novel commissioning on these services. Accredited providers were paid standard tariffs for each smoker who was supported to quit for four and 12 weeks. A cluster-controlled study design was used with the eight intervention PCTs (representing 2,138,947 adult population) matched with a control group of all other (n=64) PCTs with similar demographics which did not implement the novel commissioning arrangements. The primary outcome measure was changes in quits at four weeks between April 2009 and March 2013. A secondary outcome measure was the number of new market entrants within the group of the largest two providers at PCT-level. The number of four-week quits per 1,000 adult population increased per year on average by 9.6% in the intervention PCTs compared to a decrease of 1.1% in the control PCTs (incident rate ratio 1108, p<0001, 95% CI 1059 to 1160). Eighty-five providers held 'any qualified provider' contracts for stop smoking services across the eight intervention PCTs in 2011/12, and 84% of the four-week quits were accounted for by the largest two providers at PCT-level. Three of these 10 providers were new market entrants. To the extent that the intervention incentivized providers to overstate quits in order to increase income, caution is appropriate when considering the findings. Novel commissioning to incentivize achievement of specific clinical outcomes and attract new service providers can increase the effectiveness and supply of NHS stop smoking services.
dc.language.isoenen
dc.rights© 2015 McLeod et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
dc.subjectAdult
dc.subjectCluster analysis
dc.subjectCost-benefit analysis
dc.subjectEngland
dc.subjectFemale
dc.subjectFollow-up studies
dc.subjectHumans
dc.subjectMale
dc.subjectOutcome assessment
dc.subjectPublic health
dc.subjectSmoking
dc.subjectSmoking cessation
dc.subjectSocial class
dc.subjectState medicine
dc.subjectTime factors
dc.titleEffect of pay-for-outcomes and encouraging new providers on national health service smoking cessation services in England: a cluster controlled study
dc.status.refereedYes
dc.date.Accepted2015-03-02
dc.typeArticle
dc.type.versionPublished version
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0123349
refterms.dateFOA2018-07-25T13:38:02Z


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