Financial inducements and patient care

Payments to Australian GPs are no longer limited to consultation fees. Other countries also offer incentive payments to GPs who carry out specific activities. Australian reviewers have therefore assessed the effect of these payments on the quality of care.

The reviewers searched for randomised trials, time-series analyses, and before and after studies. Only seven studies were suitable for the review and most of these had a substantial risk of bias.

Five studies were from the USA and involved incentives offered by private healthcare plans. Some schemes reduced payments to practices and then used the pool of money to pay bonuses to the better performers.

Three trials studied incentives for doctors to help patients quit smoking. Payments increased referral rates and the recording of patients’ smoking habits, but had no significant effect on smoking cessation.

The effects of payments on screening and diabetes care were examined in three