title: Compliance with quality prescribing indicators linked to financial incentives: what about not incentivized indicators?: an observational study.
abstract: OBJECTIVE
  The aims of this study were to investigate whether general practitioners (GPs) who complied with quality prescribing indicators included in the pay-for-performance programmes also complied with quality prescribing indicators which are not linked to incentives and to compare the prescribing behaviour between those GPs who showed compliance with quality prescribing indicators linked to financial incentives and those who did not.
  
  
  METHODS
  This was a descriptive cross-sectional study which was conducted in 2007 in the Aljarafe Primary Care Area (Andalusia, Spain) and involved 37 Health Care Centres and 176 GPs. The main outcome was the results of a comparison of six quality prescribing indicators linked to incentives and 14 quality prescribing indicators not linked to incentives. The chi-square test was used to compare qualitative variables. Quantitative variables were tested using Student's t test upon confirmation of normality.
  
  
  RESULTS
  Those GPs showing compliance with the indicators included in the pay-for performance programme showed low levels of compliance with quality prescribing indicators that were unincentivised. With respect to compliance with the indicators not linked to financial incentives, we found no statistical difference between GPs who showed compliance with incentivised indicators (n = 57) and those showing non-compliance (n = 112) in terms of drug selection, with the exception of the selection of second- and third-line antibiotics and antihistamines, nor in terms of the appropriate use of drugs linked to patient's clinical conditions.
  
  
  CONCLUSIONS
  The compliance of GPs showing compliance with quality prescribing indicators included in pay-for-performance programmes was not better than that of those who showed no compliance with other relevant quality prescribing indicators not linked to financial incentives.
authors.affiliation: Service of Pharmacy, Aljarafe-Sevilla Norte Primary Health Care Area, Mairena del Aljarafe, Seville, Spain, rocio.fernandez.sspa@juntadeandalucia.es.
authors.forename: R
authors.initials: R
authors.lastname: Fernández Urrusuno
authors.forename: P
authors.initials: P
authors.lastname: Pérez Pérez
authors.forename: M C
authors.initials: MC
authors.lastname: Montero Balosa
authors.forename: C
authors.initials: C
authors.lastname: Márquez Calzada
authors.forename: B
authors.initials: B
authors.lastname: Pascual de la Pisa
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000191:economics / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010816:Physician Incentive Plans / Q000191:economics; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D011320:Primary Health Care / Q000191:economics / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000191:economics*; D012052:Reimbursement, Incentive / Q000191:economics*; D013030:Spain