The effect of financial incentives on the quality of health care provided by primary care physicians

Cochrane Database of Systematic Reviews, 2011

The effect of financial incentives on the quality of health care provided by primary care physicians - The Cochrane Library - Scott - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content The effect of financial incentives on the quality of health care provided by primary care physicians Anthony Scott 1,* , Peter Sivey 1 , Driss Ait Ouakrim 1 , Lisa Willenberg 1 , Lucio Naccarella 2 , John Furler 3 , Doris Young 3 Editorial Group: Published Online: 7 SEP 2011 Assessed as up-to-date: 30 AUG 2009 DOI: 10.1002/14651858.CD008451.pub2 Copyright © 2011 The Cochrane Collaboration.
The effect of financial incentives on the quality of health care provided by primary care physicians.
Publication History Publication Status: New Published Online: 7 SEP 2011 SEARCH ARTICLE TOOLS Abstract Abstract Background The use of blended payment schemes in primary care, including the use of financial incentives to directly reward ‘performance’ and ‘quality’ is increasing in a number of countries.
There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform.
Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care.
Objectives The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify: i) the different types of financial incentives that have improved quality; ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; and iii) the characteristics of PCPs who have responded to financial incentives.
Searches of Internet-based economics and health economics working paper collections were also conducted.
Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field.
Selection criteria Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs).
Quality of care was defined as patient reported outcome measures, clinical behaviours, and intermediate clinical and physiological measures.
Data collection and analysis Two review authors independently extracted data and assessed study quality, in consultation with two other review authors where there was disagreement.