OBJECTIVE We assessed the impact of a diabetes incentive code introduced for primary care physicians in Ontario, Canada, in 2002 on quality of diabetes care at the population and patient level. RESEARCH DESIGN AND METHODS We analyzed administrative data for 757,928 Ontarians with diabetes to examine the use of the code and receipt of three evidence-based monitoring tests from 2006 to 2008. We...

Introduction Increasing efforts to reform health care and contain medical expenditures have accelerated the push to define, capture, and enforce quality measures for delivered care. This trend is evident particularly for procedural and preventative measures that can have a marked effect on patient outcomes and health care costs, such as the use of colonoscopy for screening and surveillance for ...

This paper examines the role of quality improvement organizations (QIOs, formerly known as PROs, or peer review organizations) in improving the quality of medical care delivered to Medicare beneficiaries in both fee-for-service and managed care environments. It looks at the expansion of the QIOs' portfolio in their new contract cycle to include quality improvement activities in nursing homes, h...

We model a firm’s decisions about quality investment under differing external (market) and internal (cost and revenue) environments. We find that costs and benefits of expending resources on quality improvement depend on the price and quality profiles of competitors, the persistence of reputation in the marketplace, the relative efficacy of quality improvement efforts and the degree to which th...

Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered, before proposing a new more comprehensive framework, which we apply to the first P4P scheme intro...

It is well established in vertical product differentiation models that the high-quality firm reaps a larger profit in a two-stage quality-price game as long as the cost of quality improvement is zero or is borne as fixed cost in the first stage quality choice. This note shows that the highquality advantage may fail to hold if there is variable cost of production that is dependent on quality. JE...

The severity of illness in transplant patients and the complexity of transplant operations results in significant postoperative morbidity and mortality. Remarkable efforts have been made by transplant physicians to study and improve organ allocation, graft and patient survival, immunosuppression and the long-term management of post-transplant complications. Less effort has been spent studying t...

As society moves into the age of active knowledge management and sharing, inter-clinician relationships and communities of practice can be directed to support quality improvement efforts within healthcare organizations. It is argued that successful adoption of the processes that are critical to quality improvement is necessary for durable improvements in quality. Knowledge sharing is necessary ...