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Pay-for-performance programs - do they improve the quality of primary care?
1London School of Hygiene and Tropical Medicine, London, United Kingdom. wrightdrmc@gmail.com
Australian Family Physician
|December 5, 2012
Summary
Pay-for-performance (P4P) programs may influence general practitioner behavior but lack evidence of improving healthcare quality or outcomes. Further research is needed before implementing P4P in Australian general practice.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Health Policy Analysis
Background:
- The Royal Australian College of General Practitioners' release of clinical quality indicators has intensified discussions on pay-for-performance (P4P) in Australian general practice.
- P4P programs are financial incentives designed to link healthcare provider performance with quality improvements.
Purpose of the Study:
- To review current evidence on the impact of P4P programs on primary care quality.
- To present an evidence-based perspective on the limitations and potential drawbacks of P4P programs in general practice.
Main Methods:
- Systematic review of recent evidence on P4P program effectiveness.
- Analysis of theoretical links between P4P, provider behavior, and healthcare quality.
Main Results:
- P4P programs appear to influence the behavior of general practitioners.
- There is limited evidence that current P4P models improve health outcomes or overall healthcare system quality.
- P4P programs are attractive to funders due to their theoretical connection to quality and cost control.
Conclusions:
- While P4P programs show potential for influencing practitioner behavior, their current form offers little proof of enhancing healthcare quality or patient outcomes.
- Further rigorous research is essential to ascertain the true impact of P4P on healthcare quality before widespread adoption in Australian general practice.
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