학술논문
Financial Incentives And Measurement Improved Physicians' Quality Of Care In The Philippines.
Document Type
Article
Author
Source
Subject
*ANALYSIS of variance
*BEHAVIOR modification
*CASE method (Teaching)
*COMPARATIVE studies
*CONCEPTUAL structures
*EXPERIMENTAL design
*HOSPITALS
*HOSPITAL medical staff
*INFORMATION storage & retrieval systems
*MEDICAL databases
*LONGITUDINAL method
*MEDICAL care cost control
*NATIONAL health services
*EVALUATION of organizational effectiveness
*PEDIATRICS
*QUALITY assurance
*RESEARCH funding
*STATISTICAL sampling
*SURVEYS
*TIME
*HEALTH insurance reimbursement
*CONTROL groups
*REPEATED measures design
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Language
ISSN
0278-2715
Abstract
The merits of using financial incentives to improve clinical quality have much appeal, yet few studies have rigorously assessed the potential benefits. The uncertainty surrounding assessments of quality can lead to poor policy decisions, possibly resulting in increased cost with little or no quality improvement, or missed opportunities to improve care. We conducted an experiment involving physicians in thirty Philippine hospitals that overcomes many of the limitations of previous studies. We measured clinical performance and then examined whether modest bonuses equal to about 5 percent of a physician's salary, as well as system-level incentives that increased compensation to hospitals and across groups of physicians, led to improvements in the quality of care. We found that both the bonus and system-level incentives improved scores in a quality measurement system used in our study by ten percentage points. Our findings suggest that when careful measurement is combined with the types of incentives we studied, there may be a larger impact on quality than previously recognized. [ABSTRACT FROM AUTHOR]