Setback for pay-for-performance scheme

THE Gillard Government’s hopes for a future pay-for-performance diabetes scheme have been dealt another blow, with a UK study suggesting the change would encourage GP “gaming” and worsen health disparities.

A study of 4000 patients with diabetes registered with 23 London practices found that pay-for-performance – which is already fully operational in the UK – encouraged crowded or “more deprived” clinics to exclude older and longer-term patients from reporting benchmarks.

Excluded patients were less likely to achieve treatment targets, according to the study authors, who warned that “permitting physicians to exclude patients from pay-per-performance programs may worsen health disparities”.

Professor Hal Swerissen, dean of the Faculty of Health Sciences at La Trobe University, said pay-per-performance would aid diabetes care in Australia but he agreed any system introduced would need to include