Pay-for-performance may produce skewed results

AN INTERNATIONAL study has offered more evidence that pay-for-performance funding models may have negative consequences for patient care. 

Researchers studying the impact of the UK’s Quality and Outcomes Framework – which financially rewards doctors for meeting certain targets in patient care – found that significant improvements in incentivised areas of patient care were achieved at the expense of improvements in non-incentivised activities.

Researchers found in the first year of the scheme there was no impact on the rate of improvement in non-incentivised activities, but by the third year improvement rates in those indicators were “significantly below” that of incentivised activities.

The study of 148 general practices examined incentivised activities such as recording of HbA1c for patients with diabetes and recording of blood pressure and total cholesterol for patients with coronary heart disease.