Decreases in 30-Day Inpatient Mortality Not Sustained in Pay-for-Performance Study

​A pay-for-performance program did not sustain long-term decreases in 30-day mortality for certain patients, despite being associated with clinically significant decreases in the short-term (i.e., the first 18 months), according to a study in the August 7, 2014, issue of the New England Journal of Medicine. During the first 18 months of the pay-for-performance program in one region in England, researchers previously found a clinically significant decrease in 30-day in-hospital mortality and wanted to see if the effects could be sustained for another 24 months. Patients who were emergently admitted for acute myocardial infarction, heart failure, or pneumonia were the focus of the 30-day mortality evaluation for the "long-term" study. The authors found that the average performance for participating hospitals on all measures of quality improved but that the rate of improvement slowed over time, and for some conditions, such as acute myocardial infarction, the rate plateaued at high levels.