Assessment of a pay-for-performance program in primary care designed by target users
Open Access
- 20 September 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in Family Practice
- Vol. 30 (2), 161-171
- https://doi.org/10.1093/fampra/cms055
Abstract
Evidence for pay-for-performance (P4P) has been searched for in the last decade as financial incentives increased to influence behaviour of health care professionals to improve quality of care. The effectiveness of P4P is inconclusive, though some reviews reported significant effects. To assess changes in performance after introducing a participatory P4P program. An observational study with a pre- and post-measurement. Sixty-five general practices in the south of the Netherlands. A P4P program designed by target users containing indicators for chronic care, prevention, practice management and patient experience (general practitioner’s [GP] functioning and organization of care). Quality indicators were calculated for each practice. A bonus with a maximum of 6890 Euros per 1000 patients was determined by comparing practice performance with a benchmark. Quality indicators for clinical care (process and outcome) and patient experience. We included 60 practices. After 1 year, significant improvement was shown for the process indicators for all chronic conditions ranging from +7.9% improvement for cardiovascular risk management to +11.5% for asthma. Five outcome indicators significantly improved as well as patients’ experiences with GP’s functioning and organization of care. No significant improvements were seen for influenza vaccination rate and the cervical cancer screening uptake. The clinical process and outcome indicators, as well as patient experience indicators were affected by baseline measures. Smaller practices showed more improvement. A participatory P4P program might stimulate quality improvement in clinical care and improve patient experiences with GP’s functioning and the organization of care.Keywords
This publication has 30 references indexed in Scilit:
- Design choices made by target users for a pay-for-performance program in primary care: an action research approachBMC Family Practice, 2012
- Systematic review: Effects, design choices, and context of pay-for-performance in health careBMC Health Services Research, 2010
- Patient Outcomes and Evidence‐Based Medicine in a Preferred Provider Organization Setting: A Six‐Year Evaluation of a Physician Pay‐for‐Performance ProgramHealth Services Research, 2007
- A behavioral model of clinician responses to incentives to improve qualityHealth Policy, 2007
- Does Pay-for-Performance Improve the Quality of Health Care?Annals of Internal Medicine, 2006
- What Is the Empirical Basis for Paying for Quality in Health Care?Medical Care Research and Review, 2006
- A Quality-Driven Physician Compensation Model: Four-Year Follow-up StudyJournal for Healthcare Quality, 2003
- Longitudinal Assessment of a Diabetes Care Management System in an Integrated Health NetworkJournal of Managed Care Pharmacy, 2003
- Paying for Quality Improvement: Compliance with Tobacco Cessation GuidelinesThe Joint Commission Journal on Quality and Safety, 2003
- Mental Accounting and Consumer ChoiceMarketing Science, 1985