Stephen Peckham1, Andrew Wallace. 1. Reader in Health Policy, Health Services Research Unit, London School of Hygiene and Tropical Medicine, London, UK.
Abstract
BACKGROUND: Pay for performance (P4P) schemes have become increasingly popular innovations in primary care and have generated questions about their effect on improving quality of care. AIMS: To provide a brief outline of the international evidence on the relationship between P4P schemes and quality improvement. METHOD: We conducted a literature search using relevant databases and reference lists of retrieved articles which discussed P4P schemes, quality in primary care and the Quality and Outcomes Framework (QOF). These included two recent systematic reviews of P4P schemes. RESULTS: Evidence on the effect of P4P on quality is limited. What we can say is that P4P schemes can have an effect on the behaviour of physicians and can lead to better clinical management of disease, but that there is cause for concern about the impact on the quality of care. CONCLUSION: P4P schemes need to take more account of broader definitions of quality, as whilst they can have a positive impact on incentivised clinical processes, it is not clear that this translates into improving the experience and outcome of care.
BACKGROUND: Pay for performance (P4P) schemes have become increasingly popular innovations in primary care and have generated questions about their effect on improving quality of care. AIMS: To provide a brief outline of the international evidence on the relationship between P4P schemes and quality improvement. METHOD: We conducted a literature search using relevant databases and reference lists of retrieved articles which discussed P4P schemes, quality in primary care and the Quality and Outcomes Framework (QOF). These included two recent systematic reviews of P4P schemes. RESULTS: Evidence on the effect of P4P on quality is limited. What we can say is that P4P schemes can have an effect on the behaviour of physicians and can lead to better clinical management of disease, but that there is cause for concern about the impact on the quality of care. CONCLUSION: P4P schemes need to take more account of broader definitions of quality, as whilst they can have a positive impact on incentivised clinical processes, it is not clear that this translates into improving the experience and outcome of care.
Authors: Helen T Allan; Sally Brearley; Richard Byng; Sara Christian; Julie Clayton; Maureen Mackintosh; Linnie Price; Pam Smith; Fiona Ross Journal: Health Serv Res Date: 2013-07-05 Impact factor: 3.402
Authors: James Close; Ben Fosh; Hannah Wheat; Jane Horrell; William Lee; Richard Byng; Michael Bainbridge; Richard Blackwell; Louise Witts; Louise Hall; Helen Lloyd Journal: BMJ Open Date: 2019-07-23 Impact factor: 2.692