An Examination of Pay‐for‐Performance in General Practice in Australia

Health Services Research - Tập 48 Số 4 - Trang 1415-1432 - 2013
Jessica Greene1
1Department of Planning, Public Policy & Management, University of Oregon, Eugene, OR

Tóm tắt

ObjectiveThis study examines the impact of Australia's pay‐for‐performance (P4P) program for general practitioners (GPs). The voluntary program pays GPs A$40 and A$100 in addition to fee‐for‐service payment for providing patients recommended diabetes and asthma treatment over a year, and A$35 for screening women for cervical cancer who have not been screened in 4 years.DesignThree approaches were used to triangulate the program's impact: (1) analysis of trends in national claims for incentivized services pre‐ and postprogram implementation; (2) fixed effects panel regression models examining the impact of GPs' P4P program participation on provision of incentivized services; and (3) in‐depth interviews to explore GPs' perceptions of their own response to the program.ResultsThere was a short‐term increase in diabetes testing and cervical cancer screens after program implementation. The increase, however, was for all GPs. Neither signing onto the program nor claiming incentive payments was associated with increased diabetes testing or cervical cancer screening. GPs reported that the incentive did not influence their behavior, largely due to the modest payment and the complexity of tracking patients and claiming payment.ImplicationsMonitoring and evaluating P4P programs is essential, as programs may not spark the envisioned impact on quality improvement.

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Tài liệu tham khảo

Australian Department of Health and Ageing.2009. “Primary Health Care Reform in Australia. Report to Support Australia's First National Primary Health Care Strategy.” Commonwealth of Australia.

Britt H. G. C.Miller J.Charles S.Knox G. P.Sayer L.Valenti J.Henderson andZ.Kelly.2000. “General Practice Activity in Australia 1999–2000.” AIHW and Sydney University.

10.1186/1472-6963-11-272

10.1056/NEJMsa0807651

10.1377/hlthaff.26.3.w405

Christianson J. B. S.Leatherman andK.Sutherland.2008. “Lessons from Evaluations of Purchaser Pay‐for‐performance Programs: A Review of the Evidence.” pp.5S–35S.

10.1503/cmaj.109-3068

10.1016/S0140-6736(08)61123-X

Georgiou A., 2004, GP Claims for Completing Diabetes' Cycle of Care', Australian Family Physician, 33

Greene J. J.Hibbard andV.Overton.2012. “Early Experiences with an Innovative Primary Care Compensation Model.” Presented at the AcademyHealth Annual Research Meeting.

10.5694/j.1326-5377.2007.tb01152.x

10.1377/hlthaff.23.3.89

Lerner M., 2011, Star Tribune

10.1056/NEJMsa022615

Medicare Australia.2010. “Practice Incentives Program” [accessed on December 22 2012]. Available athttp://www.medicareaustralia.gov.au/provider/incentives/pip/index.jsp

Medicare Australia.2001. “Practice Incentives Program (PIP) November 2001 Quarterly News Update” [accessed on November 30 2001]. Available athttp://www.medicareaustralia.gov.au/provider/incentives/pip/files/pip_news_nov_2001.pdf

Oregon House Bill3650.2012. “Health System Transformation.”

10.1377/hlthaff.27.4.1167

10.7326/0003-4819-145-4-200608150-00006

Pink B..2008. “Socio‐Economic Indexes for Areas (SEIFA) – Technical Paper.” Australian Bureau of Statistics: Commonwealth of Australia.

PRNewswire, 2010, Independence Blue Cross Invests $47 Million in New Physician Payment Model to Help Strengthen Primary Care, Fierce Health Care

Saunders M., 2008, Diabetes ‘Cycles of Care’ in General Practice – Do Government Incentives Help?, Australian Family Physician, 37, 781

10.1002/hec.1509

10.1002/hec.1536

Scott A., 2011, The Effect of Financial Incentives on the Quality of Health Care Provided by Primary Care Physicians, Cochrane Database of Systematic Reviews 2011, 9, 1

Seddon M., 2001, Systematic Review of Studies of Quality of Clinical Care in General Practice in the UK, Australia and New Zealand, Quality in Health Care, 10, 152, 10.1136/qhc.0100152

Stremikis K., 2010, Health Care Opinion Leaders' Views on Transparency and Pricing

10.1016/S0195-668X(02)00700-5

10.1111/j.1365-2753.2009.01287.x

10.1186/1472-6963-10-247

Zwar N. A., 2005, General Practitioner Views on Barriers and Facilitators to Implementation of the Asthma 3 +  Visit Plan, Medical Journal of Australia, 183, 4

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Health Services Research

Tập 48 Số 4

1415-1432

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