Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 353-371 |
| Number of pages | 19 |
| Journal | Health Economics |
| Volume | 24 |
| Issue number | 3 |
| Early online date | 5 Jan 2014 |
| DOIs | |
| Publication status | Published - Mar 2015 |
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Keywords
- financial incentives
- quality and outcomes framework
- general practitioners
Cite this
The Tougher the Better : An Economic Analysis of Increased Payment Thresholds on the Performance of General Practices. / Feng, Yan; Ma, Ada; Farrar, Shelley; Sutton, Matt.
In: Health Economics, Vol. 24, No. 3, 03.2015, p. 353-371.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The Tougher the Better
T2 - An Economic Analysis of Increased Payment Thresholds on the Performance of General Practices
AU - Feng, Yan
AU - Ma, Ada
AU - Farrar, Shelley
AU - Sutton, Matt
N1 - Acknowledgements This paper was carried out whilst Yan Feng was a PhD student in the Health Economics Research Unit, University of Aberdeen. The PhD was funded by the Institute of Applied Health Sciences, University of Aberdeen PhD studentship. The paper was written up when Yan was working in the Office of Health Economics (OHE). We would like to thank Luís Silva Miguel and the audience for their comments on this work during the tenth European Health Economics Workshop. We also thank Hugh Gravelle, Nancy Devlin, Stephen Morris, Marjon van der Pol, Robert Elliot and Mandy Ryan for their comments and suggestions. The Health Economics Research Unit (HERU) is funded by the Chief Scientist Office of the Scottish Government Health Directorates (SGHD). The views in this paper are those of the authors and not HERU, SGHD or OHE.
PY - 2015/3
Y1 - 2015/3
N2 - We investigate whether and how a change in performance-related payment motivated General Practitioners (GPs) in Scotland. We evaluate the effect of increases in the performance thresholds required for maximum payment under the Quality and Outcomes Framework in April 2006. A difference-in-differences estimator with fixed effects was employed to examine the number of patients treated under clinical indicators whose payment schedules were revised and to compare these with the figures for those indicators whose schedules remained unchanged. The results suggest that the increase in the maximum performance thresholds increased GPs' performance by 1.77% on average. Low-performing GPs improved significantly more (13.22%) than their high-performing counterparts (0.24%). Changes to maximum performance thresholds are differentially effective in incentivising GPs and could be used further to raise GPs' performance across all indicators
AB - We investigate whether and how a change in performance-related payment motivated General Practitioners (GPs) in Scotland. We evaluate the effect of increases in the performance thresholds required for maximum payment under the Quality and Outcomes Framework in April 2006. A difference-in-differences estimator with fixed effects was employed to examine the number of patients treated under clinical indicators whose payment schedules were revised and to compare these with the figures for those indicators whose schedules remained unchanged. The results suggest that the increase in the maximum performance thresholds increased GPs' performance by 1.77% on average. Low-performing GPs improved significantly more (13.22%) than their high-performing counterparts (0.24%). Changes to maximum performance thresholds are differentially effective in incentivising GPs and could be used further to raise GPs' performance across all indicators
KW - financial incentives
KW - quality and outcomes framework
KW - general practitioners
U2 - 10.1002/hec.3022
DO - 10.1002/hec.3022
M3 - Article
VL - 24
SP - 353
EP - 371
JO - Health Economics
JF - Health Economics
SN - 1057-9230
IS - 3
ER -