Lavergne 2018.
Methods | Interrupted time series study |
Participants | Primary care physicians |
Interventions | British Columbia, Canada Intervention: Pay‐for‐performance plus existing payment. Incentive payments targeting chronic disease management, including CAD 75 for diabetes (later increased to CAD 125), CAD 50 for hypertension, and CAD 125 for Chronic Obstructive Pulmonary Disease per patient; and the payment was based on performance for which the physicians needed to submit the charts for patients. Tha charts need include documentation of relevant guideline indicated processes of care and flow sheets or care plan templates for each condition should be available as part of billing guides for performance check and payment purpose. Control: existing payment, the province‐wide fee‐for‐service system |
Outcomes | Primary care visits: number of visits with any primary care physician Continuity of care: percent of primary care visits across the whole study population in each month that occurred with patients' usual providers of care assigned over the preceding year Testing and pharmaceutical dispensing: rates of anatomic therapeutic chemical testing and antihypertensive dispensing Hospitalization: all acute admissions, hospital admissions through the emergency department, and admissions for selected conditions, including acute myocardial infarction, stroke and heart failure among hypertension patients, and Chronic Obstructive Pulmonary Disease patients Health care spending: total constant dollar spending, and spending on primary care physicians, medical specialists, surgical specialists, laboratory services, imaging, pharmaceutical use, acute care, and day surgery |
Notes |