Little is known about the effect of a pay-for-performance system (P4P) on primary medical care providers and even less is known about its potential impact in dentistry. Based on the growing acceptance of performance-based reimbursements in medicine and the dissemination of innovative technologies, structures, and processes of care from medical to dental services, it is likely that the dental profession will face performance-based payments in the not-too-distant future. In this paper, we present the current experience of P4P in primary medical care that has relevance to dentistry and discuss the dental performance-based programs to date. Taking into consideration these lessons, the structure of dental service delivery in the United States, and the paucity of evidence-based quality indicators in dentistry, we provide several guidelines for the design of P4P pilot programs for dental services. We conclude that large-scale implementation of P4P for dentistry may not be a realistic option before significant progress is achieved in quality of dental care indicators.
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http://dx.doi.org/10.1111/j.1945-1474.2009.00064.x | DOI Listing |
J Am Med Dir Assoc
December 2024
Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli County, Taiwan. Electronic address:
Objectives: To evaluate the long-term effects of pay-for-performance (P4P) care in the geriatric population with newly diagnosed type 2 diabetes (T2D).
Design: Retrospective longitudinal cohort study.
Setting And Participants: A total of 6607 propensity score-matched pairs of patients with newly diagnosed T2D who received either P4P care or standard care as identified from the National Health Insurance Research Database in Taiwan between January 1, 2000, and December 31, 2019.
BMJ Open
November 2024
Centre for Health Services Studies, University of Kent, Canterbury, UK.
Objectives: The primary focus of pay-for-performance (P4P) schemes in the UK has traditionally been related to the public health and inclusion elements related to the activities of doctors with comparatively less attention given to nursing care as a component of the scheme. However, nursing is an integral part of healthcare delivery in the National Health Service and nurses constitute the major group of healthcare professionals in most countries. Our aim was to explore advanced nurse practitioner (ANPs) experiences of the Quality and Outcomes Framework (QOF), using the Implicit Leadership Theory (ILT) frame.
View Article and Find Full Text PDFBackground: Substance use disorders (SUDs) have a serious adverse impact on the physical and mental well-being of people with HIV. Previously, using a 39-site dual-randomized type 2 hybrid trial design, findings from the Substance Abuse Treatment to HIV Care Project supported the Implementation and Sustainment Facilitation (ISF) strategy to improve implementation and effectiveness of a motivational interviewing brief intervention (MIBI) for SUD within HIV service settings across the United States (US). Building on this trial, this parallel cluster-randomized type 3 hybrid trial aimed to test the incremental effectiveness of a pay-for-performance (P4P), a form of the "alter incentive/allowance structures" strategy.
View Article and Find Full Text PDFHealth Policy Plan
August 2024
Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
The design of complex health systems interventions, such as pay for performance (P4P), can be critical to determining such programmes' success. In P4P programmes, the design of financial incentives is crucial in shaping how these programmes work. However, the design of such schemes is usually homogenous across providers within a given scheme.
View Article and Find Full Text PDFHealth Policy Plan
June 2024
Faculty of Ceilândia, University of Brasilia, Brasilia 72220-275, Brazil.
Pay-for-performance (P4P) schemes have been shown to have mixed effects on health care outcomes. A challenge in interpreting this evidence is that P4P is often considered a homogenous intervention, when in practice schemes vary widely in their design. Our study contributes to this literature by providing a detailed depiction of incentive design across municipalities within a national P4P scheme in Brazil [Primary Care Access and Quality (PMAQ)] and exploring the association of alternative design typologies with the performance of primary health care providers.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!