Related Experiment Video
Updated: May 18, 2026
06:28
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Assessment of a pay-for-performance program in primary care designed by target users
Kirsten Kirschner1, Jozé Braspenning, Reinier P Akkermans
1Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, PO Box 9101, Nijmegen 6500 HB, The Netherlands. k.kirschner@iq.umcn.nl
Family Practice
|September 22, 2012
Summary
Participatory pay-for-performance (P4P) programs improved clinical care quality and patient experiences. While not all indicators showed improvement, chronic care processes and GP functioning saw significant gains.
Area of Science:
- Healthcare Management
- Quality Improvement in Medicine
- General Practice Research
Background:
- Pay-for-performance (P4P) financial incentives aim to enhance healthcare professional behavior and care quality.
- Evidence on P4P effectiveness remains inconclusive, despite some reviews indicating positive effects.
Purpose of the Study:
- To evaluate performance changes following the implementation of a participatory P4P program.
- Assessing the impact of a user-designed P4P initiative on various healthcare domains.
Main Methods:
- Observational study with pre- and post-intervention measurements in 65 general practices in the Netherlands.
- A participatory P4P program included indicators for chronic care, prevention, practice management, and patient experience.
- Performance was benchmarked against a set bonus structure, with quality indicators calculated for each practice.
Main Results:
- Significant improvements observed in process indicators for chronic conditions (e.g., cardiovascular risk management, asthma care).
- Five outcome indicators and patient experiences with general practitioner (GP) functioning and care organization showed significant enhancement.
- No significant improvements were noted for influenza vaccination rates or cervical cancer screening uptake; smaller practices demonstrated greater improvement.
Conclusions:
- Participatory P4P programs show potential for stimulating quality improvement in clinical care.
- These programs may also enhance patient experiences regarding GP functioning and the organization of healthcare services.
Related Concept Videos
01:30Primary Healthcare Services
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:13Patient-centered Care
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:11Secondary Healthcare System
Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
01:29Issues And Trends In Healthcare Delivery System
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...