Effects of pay for performance on the quality of primary care in England.

@article{Campbell2009EffectsOP,
  title={Effects of pay for performance on the quality of primary care in England.},
  author={Stephen M Campbell and David Reeves and Evangelos Kontopantelis and Bonnie Sibbald and Martin Roland},
  journal={The New England journal of medicine},
  year={2009},
  volume={361 4},
  pages={
          368-78
        }
}
BACKGROUND A pay-for-performance scheme based on meeting targets for the quality of clinical care was introduced to family practice in England in 2004. METHODS We conducted an interrupted time-series analysis of the quality of care in 42 representative family practices, with data collected at two time points before implementation of the scheme (1998 and 2003) and at two time points after implementation (2005 and 2007). At each time point, data on the care of patients with asthma, diabetes, or… 

Figures and Tables from this paper

Changes in Patient Experiences of Primary Care During Health Service Reforms in England Between 2003 and 2007

There was a modest improvement in access to care for patients with chronic illness, but all patients now find it somewhat harder to obtain continuity of care.

Assessment of a pay-for-performance program in primary care designed by target users.

A participatory P4P program might stimulate quality improvement in clinical care and improve patient experiences with GP's functioning and the organization of care.

The Relationship Between Financial Incentives and Quality of Diabetes Care in Ontario, Canada

It is suggested that physicians who provide the highest quality care prior to incentives may be those most likely to claim incentive payments.

Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study

Generous financial incentives, as designed in the UK pay for performance policy, may not be sufficient to improve quality of care and outcomes for hypertension and other common chronic conditions.

Is the distribution of care quality provided under pay-for-performance equitable? Evidence from the Advancing Quality programme in England

Retrospective analysis of performance data reported by hospitals, examining how the probability of receiving 23 indicators varied by patients’ area deprivation using logistic regression controlling for age and gender found quality in secondary care is not systemically distributed by income deprivation under P4P.

Impacts of pay for performance on the quality of primary care

If P4P in primary care is to have a long-term future, the question about scheme effectiveness needs to be answered robustly and that new schemes be designed from the onset to support their evaluation: control and treatment groups, coupled with before and after data.

Pay for Performance in Primary Care: The Use of Administrative Data by Health Economists

The purpose of this chapter is to report how researchers in health economics and management have benefited from the linkage of several administrative datasets to measure the performance and analyse

Incentive-Based Primary Care: Cost and Utilization Analysis.

It is shown that the funding model used in British Columbia using incentive payments for primary care might reduce health care costs and hospital utilization, as shown in the literature on pay for performance.

Patients' views on pay for performance in France: a qualitative study in primary care.

Patients in France had not noticed any modification in their medical care since implementation of pay for performance, but could understand the need for change in the remuneration policy and expressed their agreement about performance-based remunerations if, and only if, it is not the cause of depersonalised health care.
...

References

SHOWING 1-10 OF 25 REFERENCES

Improvements in quality of clinical care in English general practice 1998-2003: longitudinal observational study

Substantial improvements were seen in quality of care for the three conditions studied between 1998 and 2003, a time of systematic quality improvement initiatives in the NHS.

Early experience with pay-for-performance: from concept to practice.

Paying clinicians to reach a common, fixed performance target may produce little gain in quality for the money spent and will largely reward those with higher performance at baseline.

Public reporting and pay for performance in hospital quality improvement.

Hospitals engaged in both public reporting and pay for performance achieved modestly greater improvements in quality than did hospitals engaged only in public reporting.

Identifying predictors of high quality care in English general practice: observational study

Good teamworking is a key part of providing high quality care across a range of areas and may need specific support if quality of care is to be improved and additional support is needed to provide preventive care to deprived populations.

Linking physicians' pay to the quality of care--a major experiment in the United kingdom.

  • M. Roland
  • Medicine, Economics
    The New England journal of medicine
  • 2004
A major pay-for-performance program that is being implemented in the United Kingdom where family practitioners can earn up to 1050 quality bonus points for performing well on a complex set of indicators that measure the quality of clinical care.

Quality of primary care in England with the introduction of pay for performance.

The authors examine longitudinal data on quality and report that the incentive program may have prompted a modest improvement in the quality of care for two of the three chronic conditions they studied.

Pay for Performance in Primary Care in England and California: Comparison of Unintended Consequences

The study findings suggest that unintended consequences of incentive programs relate to the way in which these programs are designed and implemented, and although unintended, these consequences are not necessarily unpredictable.

What Patients Want From Primary Care Consultations: A Discrete Choice Experiment to Identify Patients’ Priorities

Although patient-centered care is important to patients, they may place higher priority on the technical quality of care and continuity of care.

Development of review criteria for assessing the quality of management of stable angina, adult asthma, and non-insulin dependent diabetes mellitus in general practice.

The results show the importance of a systematic approach to combining evidence with expert opinion to develop review criteria for assessing the quality of three chronic diseases in general practice.