Do financial incentives for delivering health promotion counselling work? Analysis of smoking cessation activities stimulated by the quality and outcomes framework

BMC Public Health

Debate

Tim Coleman¹ 

[1] Reader in Primary Care, UK Centre for Tobacco Control Studies, Division of Primary Care, University of Nottingham, Medical School, Queen's Medical Centre, NG7 2UH, Nottingham, UK;

关键词: Smoking Cessation;    Nicotine Replacement Therapy;    Varenicline;    Smoking Cessation Intervention;    Smoking Cessation Advice;   

DOI  :  10.1186/1471-2458-10-167

 received in 2009-11-06, accepted in 2010-03-26,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundA substantial fraction of UK general practitioners' salaries is now intended to reflect the quality of care provided. This performance-related pay system has probably improved aspects of primary health care but, using the observational data available, disentangling the impacts of different types of targets set within this unique payment system is challenging.DiscussionFinancial incentives undoubtedly influence GPs' activities, however, those aimed at encouraging GPs' delivery of health promotion counselling may not always have the effects intended. There is strong, observational evidence that targets and incentives intended to increase smoking cessation counselling by GPs have merely increased their propensity to record this activity in patients' medical records. The limitations of using financial incentives to stimulate the delivery of counselling in primary care are discussed and a re-appraisal of their use within UK GPs' performance-related pay system is argued for.SummaryThe utility of targets employed by the system for UK General Practitioners' performance related pay may be inappropriate for encouraging the delivery of health promotion counselling interventions. An evaluation of these targets is essential before they are further developed or added to.

【 授权许可】

CC BY   
© Coleman; licensee BioMed Central Ltd. 2010