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Dr Peter Sivey
Melbourne Institute of Applied Economic & Social Research
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While the idea behind giving financial incentives to high performing doctors is to provide a reward and therefore encourage doctors to provide high quality care, study author Dr Peter Sivey said results on the effectiveness of this method were far from conclusive.
“There is insufficient evidence to either support or reject the practice of using pay to provide incentives for high quality care.”
“There are hundreds of schemes across the world, many in the US and the UK, where the payment of doctors is deliberately organised to change the way GPs work. However, despite the popularity of these schemes, the review found only seven studies with high-quality data evaluating the effectiveness of these policies at improving quality of care. Overall the studies found small or zero effects of the incentive schemes and had a high risk of bias,” Dr Sivey said.
Dr Sivey said the study had identified the possibility that incentive schemes may not produce any effect and could even have unintended consequences. “In some situations where financial incentives are in place, they may work well for one disease area, but at the cost of doctors spending less time with other disease areas,” Dr Sivey explained.
The findings are significant for policymakers in Australia, which may be considering such a scheme.
”The National Health and Hospitals Reform Commission recommended setting up financial incentives for General Practitioners to reward high quality of care, so this is something already on the table in Australia,” Dr Sivey said.
“The Federal Government is funding a $30.2 million pilot of financial incentives for diabetes care. This pilot should provide an opportunity to further analyse the benefits and drawbacks of financial incentives for GPs in the Australian context.”
The study, published in the latest edition of The Cochrane Library, was co-written by the Melbourne Institute’s Prof Anthony Scott, Driss Ait Ouakrim and Lisa Willenberg as well as Dr Lucio Naccarella (the Australian Health Workforce Institute), and Dr John Furler and Prof Doris Young (Department of General Practice, University of Melbourne).