Background Pay-for-performance programmes are increasingly used as tools to improve health service quality, contain costs, foster efficiency and improve patient health outcomes. These programmes use financial incentives to explicitly reward adherence to predefined standards of care and cost control. Given the strong impact of primary care on patient use of healthcare services, general practitioners are a natural target for cost-containment strategies, including pay-for-performance. Purpose This study presents a preliminary investigation on the applicability of the German study conducted by Krauth et al (2016) to the context of an Italian region. The survey aimed: (1) to assess the attitudes of general practitioners towards the current remuneration scheme; (2) to determine if general practitioners would participate in a pay-for-performance programme; and (3) to analyse how the responses vary among the general practitioners and in what way with respect to age and sex, including a first comparison of our study with the work of Krauth et al. (2016). Design/methodology/approach A survey was conducted among a small sample of general practitioners in Calabria (South Italy). The tool for data collection was a questionnaire elaborated on the basis of the theoretical framework developed by Krauth et al. (2016). Findings Most of the general practitioners were dissatisfied about the current remuneration scheme. According to this, almost all respondents were in favour of the remuneration scheme reform. However, most respondents required a greater bonus than the one offered. The preliminary comparison with the German case showed major differences in respondent attitudes towards P4P. According to the Italian general practitioners’ answers, the introduction of P4P programmes may increase simplicity understandability, fairness of the remuneration scheme, and the control of doctors, ensuring treatment’s homogeneity. Research limitations/implications Our analysis was based on a preliminary sample of 50 General Practitioners. The sample size could not provide a definitive analysis. However, this preliminary investigation represents the first step of an ongoing project that, starting from the evaluation of the applicability of the German study to the context of the Calabria region, it will provide a first evidence and it will contribute to create a study that is easily adaptable to the Italian context with the aims of providing useful information for the ongoing debate on pay-for-performance programmes in primary care. Practical implications The paper includes implications for the development of an effectiveness remuneration scheme in the general practice. Policymakers who design and implement P4P programmes should effectively communicate with healthcare providers. To ensure that healthcare providers can realistically achieve the programme’s targets, they should be involved in the implementation process. Originality/value This paper fulfils an identified need to study how the implementation of the pay for performance scheme can be done.

Preliminary investigation into general practitioners’ willingness to accept the pay-for-performance scheme: A replication study

Lopreite Milena.;Mauro Marianna.
2018

Abstract

Background Pay-for-performance programmes are increasingly used as tools to improve health service quality, contain costs, foster efficiency and improve patient health outcomes. These programmes use financial incentives to explicitly reward adherence to predefined standards of care and cost control. Given the strong impact of primary care on patient use of healthcare services, general practitioners are a natural target for cost-containment strategies, including pay-for-performance. Purpose This study presents a preliminary investigation on the applicability of the German study conducted by Krauth et al (2016) to the context of an Italian region. The survey aimed: (1) to assess the attitudes of general practitioners towards the current remuneration scheme; (2) to determine if general practitioners would participate in a pay-for-performance programme; and (3) to analyse how the responses vary among the general practitioners and in what way with respect to age and sex, including a first comparison of our study with the work of Krauth et al. (2016). Design/methodology/approach A survey was conducted among a small sample of general practitioners in Calabria (South Italy). The tool for data collection was a questionnaire elaborated on the basis of the theoretical framework developed by Krauth et al. (2016). Findings Most of the general practitioners were dissatisfied about the current remuneration scheme. According to this, almost all respondents were in favour of the remuneration scheme reform. However, most respondents required a greater bonus than the one offered. The preliminary comparison with the German case showed major differences in respondent attitudes towards P4P. According to the Italian general practitioners’ answers, the introduction of P4P programmes may increase simplicity understandability, fairness of the remuneration scheme, and the control of doctors, ensuring treatment’s homogeneity. Research limitations/implications Our analysis was based on a preliminary sample of 50 General Practitioners. The sample size could not provide a definitive analysis. However, this preliminary investigation represents the first step of an ongoing project that, starting from the evaluation of the applicability of the German study to the context of the Calabria region, it will provide a first evidence and it will contribute to create a study that is easily adaptable to the Italian context with the aims of providing useful information for the ongoing debate on pay-for-performance programmes in primary care. Practical implications The paper includes implications for the development of an effectiveness remuneration scheme in the general practice. Policymakers who design and implement P4P programmes should effectively communicate with healthcare providers. To ensure that healthcare providers can realistically achieve the programme’s targets, they should be involved in the implementation process. Originality/value This paper fulfils an identified need to study how the implementation of the pay for performance scheme can be done.
General practice, Pay for performance, Italy, Health services quality, Health outcomes, Remuneration scheme
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11770/296209
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