OBJECTIVE: To develop quality prescribing indicators for general practitioners (GPs) who are non-monitored and not included in pay-for-performance programs, and to determine compliance with incentivized and non-incentivized indicators. STUDY DESIGN: Descriptive cross sectional study. SETTING: Aljarafe Primary Health Care Area (Andalusian Public Health Care Service, Spain), a rural and suburban area with a population of 323,857 inhabitants. Health assistance in this area is provided by 176 GPs in 37 health centers. Prescribing indicators were developed by a multidisciplinary group using a qualitative technique based on consensus. The members of the consensus group searched for updated recommendations focused on clinical evidence. Prescribing data were obtained from the computerised pharmacy records of reimbursed drugs and clinical data from the electronic clinical databases and hospital admission records. RESULTS: Fourteen indicators based on the selection of drugs of different therapeutic groups or linked to patient´s clinical information were designed. The compliance with indicators based on the selection of drugs linked to financial incentives was higher than that of indicators not linked to financial incentives. The compliance with indicators based on clinical information varied widely. Inappropriate prescribing ranged from 7 %, in the use of long-acting beta-agonists in asthma, to 86 % in the use of drugs for the prevention of osteoporotic fractures in young women. CONCLUSIONS: This study shows better compliance by GPs with indirect and incentivized quality prescribing indicators, included in pay-for-performance programs, compared with not-incentivized indicators based on the relative use of drugs and on the appropriateness prescribing.
OBJECTIVE: To develop quality prescribing indicators for general practitioners (GPs) who are non-monitored and not included in pay-for-performance programs, and to determine compliance with incentivized and non-incentivized indicators. STUDY DESIGN: Descriptive cross sectional study. SETTING: Aljarafe Primary Health Care Area (Andalusian Public Health Care Service, Spain), a rural and suburban area with a population of 323,857 inhabitants. Health assistance in this area is provided by 176 GPs in 37 health centers. Prescribing indicators were developed by a multidisciplinary group using a qualitative technique based on consensus. The members of the consensus group searched for updated recommendations focused on clinical evidence. Prescribing data were obtained from the computerised pharmacy records of reimbursed drugs and clinical data from the electronic clinical databases and hospital admission records. RESULTS: Fourteen indicators based on the selection of drugs of different therapeutic groups or linked to patient´s clinical information were designed. The compliance with indicators based on the selection of drugs linked to financial incentives was higher than that of indicators not linked to financial incentives. The compliance with indicators based on clinical information varied widely. Inappropriate prescribing ranged from 7 %, in the use of long-acting beta-agonists in asthma, to 86 % in the use of drugs for the prevention of osteoporotic fractures in young women. CONCLUSIONS: This study shows better compliance by GPs with indirect and incentivized quality prescribing indicators, included in pay-for-performance programs, compared with not-incentivized indicators based on the relative use of drugs and on the appropriateness prescribing.
Authors: H Wollersheim; R Hermens; M Hulscher; J Braspenning; M Ouwens; J Schouten; H Marres; R Dijkstra; R Grol Journal: Neth J Med Date: 2007-01 Impact factor: 1.422
Authors: R Fernández Urrusuno; P Pérez Pérez; M C Montero Balosa; C Márquez Calzada; B Pascual de la Pisa Journal: Eur J Clin Pharmacol Date: 2013-12-03 Impact factor: 2.953
Authors: Nav Persaud; Taehoon Lee; Haroon Ahmad; Winny Li; Michael Sergio Taglione; Yathavan Rajakulasingam; Norman Umali; Andrew Boozary; Richard H Glazier; Tara Gomes; Stephen W Hwang; Peter Jüni; Michael Law; Muhammad M Mamdani; Braden Manns; Danielle Martin; Steve Morgan; Paul Oh; Andrew David Pinto; Baiju R Shah; Frank M Sullivan; Kevin E Thorpe; Karen Tu; Andreas Laupacis Journal: BMJ Open Date: 2017-06-12 Impact factor: 2.692
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