Patient-Report-Outcome-Measure and Incentives for Inpatient Chronic Care in Germany
- Tobias Romeyke
- Elisabeth Noehammer
- Harald Stummer
INTRODUCTION: In general, incentive tools like pay for performance (P4P) have positive effects regarding treatment quality and financial outcomes. As they are applicable to the clinical management of chronic conditions like asthma and diabetes, this article analyses their potential for multimodal complex treatment of chronic rheumatic diseases.
METHODS: Cost data for chronic rheumatic diseases with and without specified complex treatments and their respective remuneration are compared to permit specific statements regarding incentive aspects in a DRG setting. Moreover, several standardized Patient-Report-Outcome-Measures (PROMs) are considered in the context of complex treatment to allow not only for efficiency, but also effectiveness evaluation.
RESULTS: In total, 375 patients with complex treatment for rheumatic conditions were surveyed from 2013 to 2018. The incentive is slightly below (4,821.05 €) the costs incurred for complex treatments (4,972.44 €). The results of the used PROMs are positive as pain intensity decreased considerably (p <.001, r=0.75) and mental state complaints were reduced (p <.001).
CONCLUSIONS: PROMs are valid instruments to capture changes in patient well-being. They also help to improve clinical operations and can be used for benchmarking. The P4P approach should cover the costs incurred to ensure the incentive structure.
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