The Downside of P4P

The report, which examined conditions at Stafford Hospital in Staffordshire over a 50-month period between 2005 and 2009, cites example after example of horrific treatment: patients left unbathed and lying in their own urine and excrement; patients left so thirsty that they drank water from vases; patients denied medication, pain relief and food by callous and overworked staff members; patients who contracted infections due to filthy conditions; and patients sent home to die after being given the wrong diagnoses…

The report into what has been called the biggest scandal in the modern history of the health service found that many of the problems were due to the efforts of the hospital to meet health-service targets, like providing care within four hours to patients arriving at the emergency room. It also said that in its efforts to balance its books and save $16 million in 2006 and 2007 in order to achieve so-called foundation-trust status, which made it semi-independent of control by the central government, the hospital laid off too many people and focused relentlessly on external objectives rather than patient care.

More on this example of the failings of pay-for-performance.

Comments (6)

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  1. Devon Herrick says:

    In the case of Stafford Hospital, I suspect the reimbursement per patient is far below what is necessary to provide high quality care.

  2. Sandeep Kumar says:

    The focus should always be on the patient-care first, not the balancing books. Economic efficiency can be achieved through other means that are more patient-care centered.

  3. H. James Prince says:

    I do not miss the healthcare in the UK, not that I particularly like the healthcare here in the US.

    I suppose this supports the old adage that ‘you get what you pay for’. I certainly feel sorry for all of these people.

  4. Angel says:

    It is a shame that patient-care wasn’t the first priority. Shows a true incompetence within the system.

  5. bc says:

    It’s interesting that the NYT article includes a quote stating, basically, “this is what happens when CORPORATE interests…” I think Stafford Hospital is part of NHS and not a privately owned hospital.

    Regardles, this is what happens when providers treat patients as stats rather than individuals.

  6. Dr. Steve says:

    P4P. Isn’t that what a truly free market is?