title: How are primary care organizations using financial incentives to influence prescribing?
abstract: Primary care organizations (PCOs) in England are required to run a prescribing incentive scheme. The average payment received by general practitioners (GPs) under these schemes is not known. We conducted a longitudinal (2 year) questionnaire study of all PCOs in London and the south east of England aiming to explore the relationship between the financial incentives, the selection of prescribing indicators and success at remaining within budget. In the second year, the average reward per GP amounted to 1220 pounds (range 470 pounds-4330 pounds). Underspent PCOs made larger incentive scheme payments to their practices as did PCOs that had successfully overturned a first year overspend into a second year underspend. The size of rewards was unrelated to the selection of any particular cost- or quality-based prescribing indicator. We conclude that larger prescribing incentive scheme payments may have contributed to prescribing cost control but their effect on prescribing quality is uncertain.
authors.affiliation: GKT Department of General Practice and Primary Care, King's College London, 5 Lambeth Walk, London SE11 6SP.
authors.forename: Mark
authors.initials: M
authors.lastname: Ashworth
authors.forename: Robert
authors.initials: R
authors.lastname: Lea
authors.forename: Heather
authors.initials: H
authors.lastname: Gray
authors.forename: Gill
authors.initials: G
authors.lastname: Rowlands
authors.forename: Hugh
authors.initials: H
authors.lastname: Gravelle
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
mesh_terms: D002017:Budgets; D011307:Drug Prescriptions / Q000191:economics*; D004363:Drug Utilization / Q000191:economics* / Q000706:statistics & numerical data; D004739:England; D006801:Humans; D008131:London; D008137:Longitudinal Studies; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D012052:Reimbursement, Incentive; D013222:State Medicine / Q000191:economics*; D011795:Surveys and Questionnaires