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báo cáo khoa học: "Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol | Petersen et al. Implementation Science 2011 6 114 http www.implementationscience.eom content 6 1 114 STUDY PROTOCOL Implementation Science IMPLEMENTATION SCIENCE Open Access Design rationale and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment study protocol 1 1 1 1 1 1 Laura A Petersen Tracy Urech Kate Simpson Kenneth Pietz Sylvia J Hysong Jochen Profit Douglas Conrad2 R Adams Dudley3 Meghan Z Lutschg1 Robert Petzel4 and LeChauncy D Woodard1 Abstract Background Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment hypertension is controlled in less than one-half of United States citizens. Methods design This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure BP control in the primary care setting. Using constrained randomization we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms physician-level incentive group-level incentive combination of physician and group incentives and no incentives control . All participants at the hospital cluster were assigned to the same study arm. We enrolled 83 fulltime primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension five audit and feedback reports and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications BP control and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives the study team interviewed study participants as well as non-participant primary care personnel and leadership at study sites. Chart reviews .