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Details matter: physician responses to multiple payments for the same activity

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Details matter : physician responses to multiple payments for the same activity. / Feng, Yan; Gravelle, H.

In: Social science and medicine, Vol. 235, 112343, 08.2019.

Research output: Contribution to journalArticle

Harvard

Feng, Y & Gravelle, H 2019, 'Details matter: physician responses to multiple payments for the same activity', Social science and medicine, vol. 235, 112343. https://doi.org/10.1016/j.socscimed.2019.05.048

APA

Feng, Y., & Gravelle, H. (2019). Details matter: physician responses to multiple payments for the same activity. Social science and medicine, 235, [112343]. https://doi.org/10.1016/j.socscimed.2019.05.048

Vancouver

Feng Y, Gravelle H. Details matter: physician responses to multiple payments for the same activity. Social science and medicine. 2019 Aug;235. 112343. https://doi.org/10.1016/j.socscimed.2019.05.048

Author

Feng, Yan ; Gravelle, H. / Details matter : physician responses to multiple payments for the same activity. In: Social science and medicine. 2019 ; Vol. 235.

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@article{d9796343704e4988ab8f86610a08b526,
title = "Details matter: physician responses to multiple payments for the same activity",
abstract = "The UK Quality and Outcomes Framework rewards general practices for achieving quality indicators for chronic disease management. Some indicators are multi-rewarded. For example, there are indicators for controlling blood pressure for patients with diabetes and for patients with chronic heart disease. Thus if a patient has diabetes and heart disease the practice is rewarded twice for controlling her blood pressure. Other indicators are singly rewarded: the incentivised activity is only for patients with single specific condition. We compare general practice performance on single and multi-reward indicators. We use a 2005/6-2012/13 panel of over 800 Scottish general practices, control for practice characteristics, practice fixed effects, indicator characteristics (whether the indicator was for measurement, treatment, or intermediate outcome, maximum payment, upper thresholds), condition, and year and cluster on indicators. We find that the proportion of patients with a given condition for whom a quality indicator was achieved was higher, and the proportion who were exception reported was lower, for multi-reward indicators than for single reward indicators. We also exploit the replacement of multi-reward smoking indicators by single reward indicators in 2006/7. Compared to indicators which were always single or always multi-reward, the proportion of the relevant patients for whom the smoking indicators were achieved fell when the smoking indicators were no longer multi-reward. Fine details of pay for performance schemes matter: they affect physician behaviour and patient outcomes.",
keywords = "United Kingdom;, Pay for performance;, Physicians;, Incentives;, Contract design",
author = "Yan Feng and H. Gravelle",
note = "{\circledC} 2019 The Authors.",
year = "2019",
month = "8",
doi = "10.1016/j.socscimed.2019.05.048",
language = "English",
volume = "235",
journal = "Social Science & Medicine",
issn = "0277-9536",
publisher = "Elsevier Limited",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Details matter

T2 - Social Science & Medicine

AU - Feng, Yan

AU - Gravelle, H.

N1 - © 2019 The Authors.

PY - 2019/8

Y1 - 2019/8

N2 - The UK Quality and Outcomes Framework rewards general practices for achieving quality indicators for chronic disease management. Some indicators are multi-rewarded. For example, there are indicators for controlling blood pressure for patients with diabetes and for patients with chronic heart disease. Thus if a patient has diabetes and heart disease the practice is rewarded twice for controlling her blood pressure. Other indicators are singly rewarded: the incentivised activity is only for patients with single specific condition. We compare general practice performance on single and multi-reward indicators. We use a 2005/6-2012/13 panel of over 800 Scottish general practices, control for practice characteristics, practice fixed effects, indicator characteristics (whether the indicator was for measurement, treatment, or intermediate outcome, maximum payment, upper thresholds), condition, and year and cluster on indicators. We find that the proportion of patients with a given condition for whom a quality indicator was achieved was higher, and the proportion who were exception reported was lower, for multi-reward indicators than for single reward indicators. We also exploit the replacement of multi-reward smoking indicators by single reward indicators in 2006/7. Compared to indicators which were always single or always multi-reward, the proportion of the relevant patients for whom the smoking indicators were achieved fell when the smoking indicators were no longer multi-reward. Fine details of pay for performance schemes matter: they affect physician behaviour and patient outcomes.

AB - The UK Quality and Outcomes Framework rewards general practices for achieving quality indicators for chronic disease management. Some indicators are multi-rewarded. For example, there are indicators for controlling blood pressure for patients with diabetes and for patients with chronic heart disease. Thus if a patient has diabetes and heart disease the practice is rewarded twice for controlling her blood pressure. Other indicators are singly rewarded: the incentivised activity is only for patients with single specific condition. We compare general practice performance on single and multi-reward indicators. We use a 2005/6-2012/13 panel of over 800 Scottish general practices, control for practice characteristics, practice fixed effects, indicator characteristics (whether the indicator was for measurement, treatment, or intermediate outcome, maximum payment, upper thresholds), condition, and year and cluster on indicators. We find that the proportion of patients with a given condition for whom a quality indicator was achieved was higher, and the proportion who were exception reported was lower, for multi-reward indicators than for single reward indicators. We also exploit the replacement of multi-reward smoking indicators by single reward indicators in 2006/7. Compared to indicators which were always single or always multi-reward, the proportion of the relevant patients for whom the smoking indicators were achieved fell when the smoking indicators were no longer multi-reward. Fine details of pay for performance schemes matter: they affect physician behaviour and patient outcomes.

KW - United Kingdom;

KW - Pay for performance;

KW - Physicians;

KW - Incentives;

KW - Contract design

U2 - 10.1016/j.socscimed.2019.05.048

DO - 10.1016/j.socscimed.2019.05.048

M3 - Article

VL - 235

JO - Social Science & Medicine

JF - Social Science & Medicine

SN - 0277-9536

M1 - 112343

ER -