The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines☆☆Surveys available upon request from corresponding author.

Roski, Joachim; Jeddeloh, Robert; An, Larry; Lando, Harry A.; Hannan, Peter J.; Hall, Carmen; Zhu, Shu Hong

doi:10.1016/s0091-7435(02)00052-x

Cited by 156 publications

(158 citation statements)

References 16 publications

Supporting

Mentioning

151

Contrasting

Unclassified

Order By: Relevance

“…Two studies (Fairbrother et al 1999;Fairbrother et al 2001) found that a bonus or bonus with performance feedback incentives increased documented coverage levels for childhood immunization, but the measured increase 6 was primarily due to better documentation not better immunization practices. A study of bonus payments for smoking cessation clinics (Roski et al 2003) found a significant improvement in documentation of patient smoking status and in providing advice to quit, but no effect on quitting rates. The other two RCTs showed a significantly positive effect of using bonus payment at the practice or the clinic level: Kouides et al (1998) showed that a bonus payment for influenza immunization increased rates by 7 percent; Lawrence et al (2008) found that the clinics with P4P payments had higher level of referral rates on tobacco quitline services than the clinics without payments.…”

Section: Empirical Evidence On Physician Response To P4pmentioning

confidence: 99%

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Hurley

DeCicca

et al. 2011

View full text Add to dashboard Cite

Explicit financial incentives, especially pay-for-performance (P4P) incentives, have been extensively employed in recent years by health plans and governments in an attempt to improve the quality of health care services. This study exploits a natural experiment in the province of Ontario, Canada to identify empirically the impact of pay-for-performance (P4P) incentives on the provision of targeted primary care services, and whether physicians' responses differ by age, practice size and baseline compliance level. We use an administrative data source which covers the full population of the province of Ontario and nearly all the services provided by practicing primary care physicians in Ontario. With an individual-level data set of physicians, we employ a difference-in-differences approach that controls for both "selection on observables" and "selection on unobservables" that may cause estimation bias in the identification. We also implemented a set of robustness checks to control for confounding from the other contemporary interventions of the primary care reform in Ontario. The results indicate that, while all responses are of modest size, physicians responded to some of the financial incentives but not the others. The differential responses appear related to the cost of responding and the strength of the evidence linking a service with quality. Overall, the results provide a cautionary message regarding the effectiveness of pay-for-performance schemes for increasing quality of care.

show abstract

Section: Empirical Evidence On Physician Response To P4pmentioning

confidence: 99%

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Hurley

DeCicca

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Performance-based payment schemes (also known as target payments) establish performance indicators and targets and give health providers -as individuals or groups -financial incentives to achieve these targets. Bonus payments in the US and UK have led to increases in immunization, smoking cessation, and cervical cancer screening [27][28][29][30][31]. Overall, however, results have been mixed [32][33].…”

Section: Discussionmentioning

confidence: 99%

Strategies that promote high quality care in Indonesia

Barber

Gertler

2008

Health Policy

View full text Add to dashboard Cite

Objectives-To investigate factors predicting the quality of care received using a nationally representative dataset from Indonesia.Data Sources-The study combines two surveys in 13 provinces: a household survey of 2451 women who delivered a live birth in 1992-1998, and a facility survey that measured quality available from outpatient providers.Study design-Multivariate regressions are used to explain the quality of care received. Explanatory variables are high facility quality, maternal education, household wealth, ethnicity, and insurance.Data collection methods-Facility quality available is measured by adherence to prenatal protocols using a clinical case scenario. Quality received is measured by maternal reports about routine prenatal services received.Principle findings-High facility quality predicts an increase in quality received. Although poor households have access to the same or higher quality care compared with the least poor, the poor receive lower levels of quality. In remote regions, quality received rises with increasing levels of maternal education and household wealth.Conclusions-Improving health provider knowledge, and increasing household financial resources and information could redress inequalities in quality received among the poor and least educated.

show abstract

“…However, the overall effect was small and highly context-specific [16,28,49,61,66,67,72]. Three of four studies of physician-level financial incentives, one study of financial incentives directed toward health administrators, and four of five studies of provider-level financial incentives showed positive improvement in quality [3,9,12,28,33,44,48,64].…”

Section: Search Strategies and Criteriamentioning

confidence: 95%

“…Most pay-forperformance focused on process indicators, which were presumably under direct control of providers and/or the health system [61,72]. In contrast, various factors contributed to patient outcomes, and many, if not most, were not within clinicians' control [66]. Greater improvement was reported when rewarding process and clinical indicators as compared with patient and efficiency outcomes, respectively [64,66,72].…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

“…In contrast, various factors contributed to patient outcomes, and many, if not most, were not within clinicians' control [66]. Greater improvement was reported when rewarding process and clinical indicators as compared with patient and efficiency outcomes, respectively [64,66,72]. Stakeholder involvement in design and evaluation of measures, and strong dissemination, further enhanced improvement [16,72].…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

See 1 more Smart Citation

The Use of Three Strategies to Improve Quality of Care at a National Level

Wright

2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Improving the quality of care is essential and a priority for patients, surgeons, and healthcare providers. Strategies to improve quality have been proposed at the national level either through accreditation standards or through national payment schemes; however, their effectiveness in improving quality is controversial. Questions/purposes The purpose of this review was to address three questions: (1) does pay-for-performance improve the quality of care; (2) do surgical safety checklists improve the quality of surgical care; and (3) do practice guidelines improve the quality of care? These three strategies were chosen because there has been some research assessing their effectiveness in improving quality, and implementation had been attempted on a large scale such as entire countries.Methods We performed a literature review from 1950 forward using Medline to identify Level I and II studies. We evaluated the three strategies and their effects on processes and outcomes of care. When possible, we examined strategy implementation, patients, and systems, including provider characteristics, which may affect the relationship between intervention and outcomes with a focus on factors that may have influenced effect size. Results Pay-for-performance improved the process and to a lesser extent the outcome of care. Surgical checklists reduced morbidity and mortality. Explicit practice guidelines influenced the process and to a lesser extent the outcome of care. Although not definitively showed, clinician involvement during development of intervention and outcomes, with explicit strategies for communication and implementation, appears to increase the likelihood of positive results. Conclusion Although the cost-effectiveness of these three strategies is unknown, quality of care could be enhanced by implementing pay-for-performance, surgical safety checklists, and explicit practice guidelines. However, this review identified that the effectiveness of these strategies is highly context-specific.

show abstract

The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines☆☆Surveys available upon request from corresponding author.

Cited by 156 publications

References 16 publications

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Physician Response to Pay-for-Performance: Evidence from a Natural Experiment

Strategies that promote high quality care in Indonesia

The Use of Three Strategies to Improve Quality of Care at a National Level

Contact Info

Product

Resources

About