International Journal for Quality in Health Care 12:133-142 (2000)
© 2000 International Society for Quality in Health Care
Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues
1 Institut dÉtudes des Politiques de Santé, Paris
2 Public Health, Henri Mondor hospital, Créteil
3 Cochin hospital, Paris, France
Objective. To identify all financial incentives that had been proposed, described, or used regardless of their initial objective and, when possible, to assess the results of these incentives on costs, process or outcomes of care. Materials and methods. Systematic review of the literature. Databases searched were: Medline, Embase, HealAbstractsth Planning and Administration, Pascal, International Pharmaceutical Abstracts and the Cochrane Library. Search terms were: health professionals and type of practice, type of incentive, methodology, languages English or french, January 1993 to May 1999. Results. Financial incentives concerned the modalities of physician payment and financing of the health care system. Confounding factors included: age of the doctor, training, speciality, place and type of medical practice, previous sanctions for over-prescribing, type and severity of disease, type of insurance. Risks of financial incentives were: limited access to certain types of care, lack of continuity of care, conflict of interests between the physician and the patient. Any form of fund-holding or capitation decreased the total volume of prescriptions by 0-24%, and hospital days by up to 80% compared with fee-for-service. Annual cap on doctors' incomes resulted in referrals to colleagues when target income is reached. Discussion. Financial incentives can be used to reduce the use of health care resources, improve compliance with practice guidelines or achieve a general health target. It may be effective to use incentives in combination depending on the target set for a given health care programme.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. D. James, J. Peabody, O. Solon, S. Quimbo, and K. Hanson An Unhealthy Public-Private Tension: Pharmacy Ownership, Prescribing, And Spending In The Philippines Health Aff., July 1, 2009; 28(4): 1022 - 1033. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L Barber and P. J Gertler Empowering women to obtain high quality care: evidence from an evaluation of Mexico's conditional cash transfer programme Health Policy Plan., January 1, 2009; 24(1): 18 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Maisey, N. Steel, R. Marsh, S. Gillam, R. Fleetcroft, and A. Howe Effects of payment for performance in primary care: qualitative interview study J Health Serv Res Policy, July 1, 2008; 13(3): 133 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Biai, A. Rodrigues, M. Gomes, I. Ribeiro, M. Sodemann, F. Alves, and P. Aaby Reduced in-hospital mortality after improved management of children under 5 years admitted to hospital with malaria: randomised trial BMJ, October 27, 2007; 335(7625): 862 - 862. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A.F. Sanderson, A. A. Tahrani, G. I. Varughese, A. F. Macleod, and A. M. Epstein Pay-for-performance programs in the United Kingdom. N. Engl. J. Med., October 26, 2006; 355(17): 1832 - 1832. [Full Text] [PDF]
|
|
|
|
|
|
T. Doran, C. Fullwood, H. Gravelle, D. Reeves, E. Kontopantelis, U. Hiroeh, and M. Roland Pay-for-performance programs in family practices in the United Kingdom. N. Engl. J. Med., July 27, 2006; 355(4): 375 - 384. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. G. Shojania, S. R. Ranji, K. M. McDonald, J. M. Grimshaw, V. Sundaram, R. J. Rushakoff, and D. K. Owens Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA, July 26, 2006; 296(4): 427 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Rashidian, N Black, and I Russell Financial incentives and quality improvement Qual. Saf. Health Care, June 1, 2005; 14(3): 227 - 227. [Full Text] [PDF]
|
|
|
|
|
|
M Marshall and S Harrison It's about more than money: financial incentives and internal motivation Qual. Saf. Health Care, February 1, 2005; 14(1): 4 - 5. [Full Text] [PDF]
|
|
|
|
|
|
M. Roland Linking Physicians' Pay to the Quality of Care -- A Major Experiment in the United Kingdom N. Engl. J. Med., September 30, 2004; 351(14): 1448 - 1454. [Full Text] [PDF]
|
|
|
|
|
|
P McElduff, G Lyratzopoulos, R Edwards, R F Heller, P Shekelle, and M Roland Will changes in primary care improve health outcomes? Modelling the impact of financial incentives introduced to improve quality of care in the UK Qual. Saf. Health Care, June 1, 2004; 13(3): 191 - 197. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. BAUCHNER, L. SIMPSON, and J. CHESSARE Changing physician behaviour Arch. Dis. Child., June 1, 2001; 84(6): 459 - 462. [Full Text]
|
|