Does paying service providers by results improve recovery outcomes for drug misusers in treatment in England?
Abstract AimTo compare drug recovery outcomes in commissioning areas included in a ‘payment by results’ scheme with all other areas. DesignObservational and data linkage study of the National Drug Treatment Monitoring System, Office for National Statistics mortality database, and Police National Computer criminal records, for two years before and after introduction of the scheme. Pre‚Äźpost controlled comparison compared outcomes in participating versus non‚Äźparticipating areas following adjustment for drug use, functioning and drug treatment status. SettingDrug services in England providing publicly‚Äźfunded, structured treatment. ParticipantsAdults in treatment (between 2010 and 2014): 154,175 (10,716 in participating areas, 143,459 non‚Äźparticipating) treatment journeys in the two years before, and 148,941 (10,012 participating, 138,929 non‚Äźparticipating) after the introduction of the scheme. InterventionScheme participation, with payment to treatment providers based on patient outcomes versus all other areas. MeasurementsRate of treatment initiation; waiting time (> or