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. 2021 Jan 20;2021(1):CD011865. doi: 10.1002/14651858.CD011865.pub2

Li 2013.

Study characteristics
Methods Controlled before‐after study
Participants General practitioners
Interventions Ontario, Canada
Incentive group: P4P plus existing payment
Comparison group: existing payment (blend of FFS and capitation)
Years 1998 to 2008, intervention happened in 2003
Outcomes Quantity of health services provided (Difference‐in‐difference with physician‐specific fixed‐effect model)
Senior flu shots rate: marginal effect 2.8 percentage point increase (P = 0.007, N = 19,866), 5.1% increase over the base compliance level
Toddler immunisation rate: marginal effect 1.1 percentage point increase (P = 0.012, N = 16,826)
Pap smears rate: marginal effect 4.1 percentage point increase (P = 0.005, N = 19,926), 7.0% increase over the base compliance level
Mammograms rate: marginal effect 1.8 percentage point increase (P = 0.005, N = 19,888), 2.8% increase over the base compliance level
Colorectal cancer screenings rate: marginal effect 8.5 percentage point increase (P = 0.007, N = 19,918), 57% increase over the base compliance level
Notes High risk of bias
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk The allocation is not made by the investigator.
Allocation concealment (selection bias) High risk The allocation is not made by the investigator.
Baseline outcome measurements similar Unclear risk No comparison of outcome measurements was reported.
Baseline characteristics similar High risk At baseline, the GPs in the incentive group were younger than those in the comparison group, had fewer years of practice experience, were more likely to be female, worked more days per year, practised more intensively, had larger patient populations with slightly more females and infants, were more likely to be located in urban areas, and were more homogenous (as indicated by smaller standard deviations).
Incomplete outcome data (attrition bias)
All outcomes Low risk No incomplete outcome data
Knowledge of the allocated interventions adequately prevented Low risk The outcomes are objective.
Study adequately protected against contamination Unclear risk No more information in text
Selective reporting (reporting bias) Low risk The outcomes mentioned in the methods were reported in the results.
Other bias Low risk No more information in text