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

May 1, 2012 updated by: Robert Schutt, MD, University of Virginia

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

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

38

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Virginia
      • Charlottesville, Virginia, United States, 22902
        • Recruiting
        • University of Virginia
        • Contact:
        • Principal Investigator:
          • Robert C Schutt, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

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 Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: pay for performance
Other: financial compensation
financial monetary reimbursement
No Intervention: no pay for performance

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
compliance with composite pay for performance measure
Time Frame: 1 month
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

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
heart failure composite score
Time Frame: 1 month
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
myocardial infarction score
Time Frame: 1 month
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
readmission rate
Time Frame: 30 days
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

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Virginia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2012

Primary Completion (Anticipated)

April 1, 2013

Study Registration Dates

First Submitted

April 30, 2012

First Submitted That Met QC Criteria

May 1, 2012

First Posted (Estimate)

May 2, 2012

Study Record Updates

Last Update Posted (Estimate)

May 2, 2012

Last Update Submitted That Met QC Criteria

May 1, 2012

Last Verified

April 1, 2012

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 16033

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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