Trade union or trait d'union? Setting targets for general practitioners: A regional case study

Area of Science:

• Health Services Research
• Primary Care Management
• Healthcare Policy

Background:

• Italian general practitioners (GPs) operate as independent contractors within the National Health Service.
• GP activity and remuneration are managed at national, regional, and local levels.
• Understanding GP perceptions of target-setting is crucial for effective primary care management.

Purpose of the Study:

• To analyze the Tuscany Region's case study on primary care target-setting styles.
• To investigate the association between different target-setting approaches and GP perceptions.
• To classify target-setting styles, from financial governance (FG) to clinical governance (CG).

Main Methods:

• Comparative analysis of nine local agreements in Tuscany.
• Survey data from 102 general practitioners.
• Classification of target-setting styles based on ideal typical models.

Main Results:

• GPs demonstrated a more favorable attitude towards primary care managerial tools when quality measures were emphasized.
• Target-setting systems appear to promote GP compliance with agreements.
• These systems can also foster GP involvement in Local Health Authority (LHA) governance.

Conclusions:

• Managerial tools can shift the traditional 'trade unionist' relationship between authorities and GPs.
• These tools can act as a unifying element between regional/local authorities and general practitioners.
• Implementing effective target-setting strategies is key for improved primary care collaboration.