Related Experiment Video

Updated: Jul 8, 2026

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

Pay for performance: is it the best way to improve control of hypertension?

Tim Doran1, Catherine Fullwood

  • 1National Primary Care Research and Development Centre, University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK. tim.doran@man.ac.uk

Current Hypertension Reports
|January 8, 2008
PubMed

Insights

Pay-for-performance schemes link physician pay to quality of care. In the UK, financial incentives for hypertension care showed high achievement, but other initiatives may be responsible.

Area of Science:

  • Health Services Research
  • Health Economics
  • Cardiovascular Medicine

Background:

  • Pay-for-performance (P4P) schemes incentivize healthcare providers financially for meeting specific quality targets.
  • These schemes aim to directly correlate physician compensation with the quality of patient care delivered.
  • While P4P has shown success in improving general quality of care, its application to hypertension management has been limited.

Purpose of the Study:

  • To provide an overview of pay-for-performance schemes and their relevance to hypertension treatment.
  • To review existing evidence on the effectiveness of P4P in healthcare.
  • To analyze new data from a UK program incentivizing family practitioners for hypertensive patient care.

Main Methods:

  • Review of literature on pay-for-performance schemes and their impact on quality of care.
  • Analysis of data from a UK-based pay-for-performance program involving 6 million hypertensive patients.
  • Examination of financial incentives provided to family practitioners for achieving performance targets in hypertension management.

Main Results:

  • Findings from the UK P4P scheme indicate a strong association between substantial financial incentives and high performance in aspects of hypertensive patient care.
  • Despite high achievement levels, a significant portion of this success may be attributed to concurrent quality improvement initiatives rather than P4P alone.
  • The study highlights the potential of P4P in hypertension management but cautions against attributing all improvements solely to financial incentives.

Conclusions:

  • Pay-for-performance schemes can be associated with improved quality metrics in hypertension care.
  • The effectiveness of P4P in hypertension may be influenced by or confounded with other quality improvement efforts.
  • Further research is needed to isolate the specific impact of financial incentives within comprehensive quality improvement strategies for chronic diseases like hypertension.

Related Concept Videos

Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Blood Pressure01:30

Blood Pressure

Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...