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

This study is currently recruiting participants.
Verified April 2012 by University of Virginia
Sponsor:
Information provided by (Responsible Party):
Robert Schutt, MD, University of Virginia
ClinicalTrials.gov Identifier:
NCT01590290
First received: April 30, 2012
Last updated: May 1, 2012
Last verified: April 2012
History of Changes
  Purpose

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


Condition Intervention Phase
Myocardial Infarction
Heart Failure
 Other: financial compensation
 Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Randomized Controlled Cluster Trial of Resident Pay for Performance and Cardiovascular Outcomes

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by University of Virginia:

Primary Outcome Measures:
  • compliance with composite pay for performance measure [ Time Frame: 1 month ] [ Designated as safety issue: No ]
    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.


Secondary Outcome Measures:
  • heart failure composite score [ Time Frame: 1 month ] [ Designated as safety issue: No ]
    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.

  • myocardial infarction score [ Time Frame: 1 month ] [ Designated as safety issue: No ]
    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.

  • readmission rate [ Time Frame: 30 days ] [ Designated as safety issue: No ]
    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.


Estimated Enrollment: 38
Study Start Date: April 2012
Estimated Primary Completion Date: April 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: pay for performance Other: financial compensation
financial monetary reimbursement
No Intervention: no pay for performance

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

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
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01590290

Locations
United States, Virginia
University of Virginia Recruiting
Charlottesville, Virginia, United States, 22902
Contact: Robert C Schutt, MD     434-924-0000 ext 4234     rob.schutt@virginia.edu    
Principal Investigator: Robert C Schutt, MD            
Sponsors and Collaborators
University of Virginia
  More Information

No publications provided

Responsible Party: Robert Schutt, MD, Resident, University of Virginia
ClinicalTrials.gov Identifier: NCT01590290     History of Changes
Other Study ID Numbers: 16033
Study First Received: April 30, 2012
Last Updated: May 1, 2012
Health Authority: United States: Institutional Review Board

Additional relevant MeSH terms:
Heart Failure
Infarction
Myocardial Infarction
Heart Diseases
Cardiovascular Diseases
 Ischemia
Pathologic Processes
Necrosis
Myocardial Ischemia
Vascular Diseases

ClinicalTrials.gov processed this record on June 17, 2013