PUP 4931r Lecture Notes - Lecture 53: Ejection Fraction, Clinical Trial
16 May 2018
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Theory: Why Should P4P Help?
Goal theory:
When employees receive incentives, input, and feedback for specific,
challenging goals, they perform better (Perry, Mesch, and Paarlberg 2006).
P4P is thought to work better in occupations where job duties are concrete
and measureable (Perry, Engbergs, and Jun 2009)
P4P works best when bonus is a significant share of compensation
Yet has’t orked ell i puli ageies:
erit pay ad pay-for-performance systems in the public sector have
generally been unsuccessful,
hae little positie ipat o eployee otiatio and organizational
performance,
ad fail to show a significant relationship between pay and performance
(Perry, Mesch, and Paarlberg 2006; p. 507)
Nursing Homes Salubrious Setting for P4P?
Care mostly nontechnical, routine
Interpersonal dimension often important
Patients are chronically ill
Smaller range of treatment options and measureable conditions than
acute and other settings
Staff poorly paid
bonuses can be important motivators
Lots of room for improvement
with low-cost marginal changes in behavior
Industry is predominately private, profitmaking
Weissert & Frederick Study: Reviewed P4P Literature
Searched 1980 & 1997-2012; update 2012-2015
150 P4P citations found
Identified 35 P4P initiatives in health care settings
After exclusions, 159 discrete outcomes measured for P4P effects in 22 studies
6 randomized; 10 comparison group; 5 observational
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
When employees receive incentives, input, and feedback for specific, challenging goals, they perform better (perry, mesch, and paarlberg 2006). P4p is thought to work better in occupations where job duties are concrete and measureable (perry, engbergs, and jun 2009) P4p works best when bonus is a significant share of compensation. Smaller range of treatment options and measureable conditions than acute and other settings. Staff poorly paid bonuses can be important motivators. Lots of room for improvement with low-cost marginal changes in behavior. Identified 35 p4p initiatives in health care settings. After exclusions, 159 discrete outcomes measured for p4p effects in 22 studies. Cal(cid:272)ulated (cid:862)effe(cid:272)t sizes(cid:863) for ea(cid:272)h out(cid:272)o(cid:373)e in each study. Improvement or decline from baseline to follow-up in each outcome. Compared treatment groups to control groups in studies that had them (effect in t group minus effect in c group) 45. 4% increase in foot exams in response to incentives to perform more of them.
