Abstract / Description of output
Introduction: Financial incentives (FI) are utilised in primary and secondary care to improve quality of care delivered to patients by rewarding practices or practitioners for achieving targets.
Aims and objectives: To systematically review the evidence investigating the impact of FI for implementation of supported self-management on organisational process outcomes, individual behavioural outcomes, and health outcomes for individuals with asthma or diabetes.
Methods: We followed Cochrane methodology, using a PICOS search strategy to search 8 databases, including a broad range of implementation methodologies. Studies were classified by robustness of methodology, number of participants and quality score (Cochrane). We used narrative synthesis due to heterogeneity.
Results: We identified 2017 articles; 11 met our inclusion criteria. Self-management outcomes identified were practice or practitioner performance scores for HbA1c testing (n=9), asthma self-management plan (n=1) and emergency department (ED) visits (n=1). Three studies were part of a larger incentive scheme; one focused on asthma; seven focused on diabetes. In one asthma study, the proportion receiving 'perfect care' (which includes written self-management plan) increased, and there were fewer ED visits in another study. In 9 diabetes studies, GP performance scores improved in 2/9, were unchanged in 6/9 and deteriorated in 1/9.
Conclusions: Results for the impact of FI on the implementation of self-management were mixed. Overall, the evidence suggests no impact in diabetes and a single study showed improved processes in asthma. Further research is needed to confirm these findings and understand how FI impact on care
Aims and objectives: To systematically review the evidence investigating the impact of FI for implementation of supported self-management on organisational process outcomes, individual behavioural outcomes, and health outcomes for individuals with asthma or diabetes.
Methods: We followed Cochrane methodology, using a PICOS search strategy to search 8 databases, including a broad range of implementation methodologies. Studies were classified by robustness of methodology, number of participants and quality score (Cochrane). We used narrative synthesis due to heterogeneity.
Results: We identified 2017 articles; 11 met our inclusion criteria. Self-management outcomes identified were practice or practitioner performance scores for HbA1c testing (n=9), asthma self-management plan (n=1) and emergency department (ED) visits (n=1). Three studies were part of a larger incentive scheme; one focused on asthma; seven focused on diabetes. In one asthma study, the proportion receiving 'perfect care' (which includes written self-management plan) increased, and there were fewer ED visits in another study. In 9 diabetes studies, GP performance scores improved in 2/9, were unchanged in 6/9 and deteriorated in 1/9.
Conclusions: Results for the impact of FI on the implementation of self-management were mixed. Overall, the evidence suggests no impact in diabetes and a single study showed improved processes in asthma. Further research is needed to confirm these findings and understand how FI impact on care
| Original language | English |
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| DOIs | |
| Publication status | Published - 1 Sept 2016 |
| Event | European Respiratory Society International Congress 2016 - , United Kingdom Duration: 3 Sept 2016 → … |
Conference
| Conference | European Respiratory Society International Congress 2016 |
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| Country/Territory | United Kingdom |
| Period | 3/09/16 → … |