Imperial College London
Portrait Picture

ProfessorJenniferQuint

Faculty of Medicine, School of Public Health

Professor of Respiratory Epidemiology
 
 
 
//

Contact

 

+44 (0)20 7594 8821j.quint

 
 
//

Location

 

.922Sir Michael Uren HubWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Stone:2022:10.1136/thoraxjnl-2021-216880,
author = {Stone, P and Adamson, A and Hurst, JR and Roberts, CM and Quint, J},
doi = {10.1136/thoraxjnl-2021-216880},
journal = {Thorax},
pages = {239--246},
title = {Does pay-for-performance improve patient outcomes in acute exacerbation of COPD admissions?},
url = {http://dx.doi.org/10.1136/thoraxjnl-2021-216880},
volume = {77},
year = {2022}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: The COPD Best Practice Tariff (BPT) is a pay-for-performance scheme in England that incentivises review by a respiratory specialist within 24 hours of admission and completion of a list of key care components prior to discharge, known as a discharge bundle, for patients admitted with acute exacerbation of COPD (AECOPD). We investigated whether the two components of the COPD BPT were associated with lower 30-day mortality and readmission in people discharged following AECOPD.Methods: Longitudinal study of national audit data containing details of AECOPD admissions in England and Wales between 01 February 2017 and 13 September 2017. Data were linked with national admissions and mortality data. Mixed-effects logistic regression, using a random intercept for hospital to adjust for clustering of patients, was used to determine the relationship between the COPD BPT criteria (combined and separately) and 30-day mortality and readmission. Models were adjusted for age, sex, socioeconomic status, length of stay, smoking status, Charlson comorbidity index, mental illness and requirement for oxygen or noninvasive ventilation during admission.Results: 28 345 patients discharged from hospital following AECOPD were included. 37% of admissions conformed to the two COPD BPT criteria. No relationship was observed between BPT conforming admissions and 30-day mortality (OR: 1.09 (95% CI 0.92 to 1.29)) or readmissions (OR: 0.96 (95% CI 0.90 to 1.02)). No relationship was observed between either of the individual COPD BPT components and 30-day mortality or readmissions. However, a specialist review at any time during admission was associated with lower inpatient mortality (OR: 0.69 (95% CI 0.58 to 0.81)).Conclusion: Completion of the combined COPD BPT criteria does not appear associated with a reduction in 30-day mortality or readmission. However, specialist review was associated with reduced inpatient mortality. While it is difficult to argue that discharge bundles do not im
AU  - Stone,P
AU  - Adamson,A
AU  - Hurst,JR
AU  - Roberts,CM
AU  - Quint,J
DO  - 10.1136/thoraxjnl-2021-216880
EP  - 246
PY  - 2022///
SN  - 0040-6376
SP  - 239
TI  - Does pay-for-performance improve patient outcomes in acute exacerbation of COPD admissions?
T2  - Thorax
UR  - http://dx.doi.org/10.1136/thoraxjnl-2021-216880
UR  - http://hdl.handle.net/10044/1/90469
VL  - 77
ER  -
Download