title: Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability.
abstract: Concerns about the sustainability of current health care expenditure are focusing attention on the cost, quality and value of health care provision. Financial incentives, for example pay-for-performance (P4P), seek to reward quality and value in health care provision. There has long been an expectation that P4P schemes are coming to rheumatology. We review the available evidence about the use of incentives in this setting and provide two emerging examples of P4P schemes which may shape the future of service provision in rheumatology. Currently, there is limited and equivocal evidence in rheumatology about the impact of incentive schemes. However, reporting variation in the quality and provision of rheumatology services has highlighted examples of inefficiencies in the delivery of care. If financial incentives can improve the delivery of timely and appropriate care for rheumatology patients, then they may have an important role to play in the sustainability of health care provision.
authors.affiliation: Faculty of Pharmaceutical Sciences, University of British Columbia, 4625-2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. mark.harrison@ubc.ca.|Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada. mark.harrison@ubc.ca.
authors.forename: Mark
authors.initials: M
authors.lastname: Harrison
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Milbers
authors.affiliation: Faculty of Pharmaceutical Sciences, University of British Columbia, 4625-2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
authors.forename: Tamara
authors.initials: T
authors.lastname: Mihic
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Aslam H
authors.initials: AH
authors.lastname: Anis
mesh_terms: D005102:Health Expenditures; D006801:Humans; D009042:Motivation; D012052:Reimbursement, Incentive; D012219:Rheumatology / Q000191:economics*
keywords: Delivery of care; Health care; Health care costs; Health care sustainability; Incentives; Pay-for-performance (P4P)