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May/June 2012 Annals of Family Medicine tip sheet
Date:5/14/2012

l supports the concept of reinforcing positive behavior but argues that the literature on incentives does not yet justify such a proposal. In the editorial, Bruce Christiansen, PhD, asserts the size of incentive needed for meaningful behavior change has implications for both feasibility and cost-effectiveness. He concludes because there is a strong relation between the size of the incentive and the degree of behavior change, it seems unlikely that sufficient resources would be available to change the major, refractory behaviors that undermine health.

Rewarding Healthy BehaviorsPay Patients for Performance

By Joanne Wu, MD, MPH

Northwest Primary Care, Portland, Oregon

What Does It Cost to Change Behavior?

By Bruce A. Christiansen, PhD

University of Wisconsin, Madison

Major UK Pay-for-Performance Program Has Limited Effect on Health Inequalities

Pay-for-performance schemes have been touted as a route to reducing health care disparities, yet this analysis of the Quality and Outcomes Framework, a major pay-for-performance program in the United Kingdom, finds the introduction of the program had no effect on health care inequalities in the practices studied. Analyzing outcomes data on diabetes patients registered with 29 practices in London, researchers found the introduction of the pay-for-performance scheme was associated with initial accelerated improvements in systolic blood pressure in white and black patients, but these improvements were sustained in only black patients. Initial improvements in diastolic blood pressure in white patients and in cholesterol levels in black and white patients were not sustained after QOF was introduced. There was no beneficial impact of QOF on HbA1c levels in any ethnic group. Furthermore, the authors note existing disparities in risk factor control remained largely intact at the end of the study period. The authors conclude that targeted quality improvement strategies may be required to add
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Contact: Angela Sharma
asharma@aafp.org
913-269-2269
American Academy of Family Physicians
Source:Eurekalert

Page: 1 2 3 4 5 6 7 8

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