scholarly journals Quality-Based Payment for Medical Groups and Individual Physicians

2009 ◽  
Vol 46 (2) ◽  
pp. 172-181 ◽  
Author(s):  
James C. Robinson ◽  
Stephen M. Shortell ◽  
Diane R. Rittenhouse ◽  
Sara Fernandes-Taylor ◽  
Robin R. Gillies ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Primary Care Physicians ◽  
Pay For Performance ◽  
Fee For Service ◽  
Performance Incentives ◽  
Payment Incentives ◽  
Medical Groups ◽  
Bonus Payments ◽  
Service Basis

This paper measures the extent to which medical groups experience external pay-for-performance incentives based on quality and patient satisfaction and the extent to which these groups pay their primary care and specialist physicians using similar criteria. Over half (52%) of large medical groups received bonus payments from health insurance plans in the period 2006–2007 based on measures of quality and patient satisfaction. Medical groups facing external pay-for-performance incentives are more likely to pay their primary care physicians (odds ratio [OR] 4.5; p<.001) and specialists (OR 2.5; p=.07) based on quality and satisfaction. Groups facing capitation payment incentives to control costs are more likely to pay member physicians on salary and less likely to pay based on productivity (p<.001 for primary care; p<.05 for specialists) than groups paid by insurers on a fee-for-service basis.

Understanding Patient Satisfaction, Trust, and Loyalty to Primary Care Physicians

2008 ◽  
Vol 65 (6) ◽  
pp. 696-712 ◽  
Author(s):  
Elena A. Platonova ◽  
Karen Norman Kennedy ◽  
Richard M. Shewchuk
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Primary Care Physicians

Differences between primary care physicians and specialised neurotologists in the diagnosis of dizziness and vertigo in Japan

2020 ◽  
Vol 134 (9) ◽  
pp. 764-768
Author(s):  
T Ito ◽  
S Matsuyama ◽  
T Shiozaki ◽  
D Nishikawa ◽  
H Akioka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Patient Satisfaction ◽  
Diagnostic Accuracy ◽  
Medical Records ◽  
Primary Care Physicians ◽  
Symptom Relief ◽  
Accurate Diagnosis ◽  
High Quality

AbstractObjectiveVertigo and dizziness are frequent symptoms in patients at out-patient services. An accurate diagnosis for vertigo or dizziness is essential for symptom relief; however, it is often challenging. This study aimed to identify differences in diagnoses between primary-care physicians and specialised neurotologists.MethodIn total, 217 patients were enrolled. To compare diagnoses, data was collected from the reference letters of primary-care physicians, medical questionnaires completed by patients and medical records.ResultsIn total, 62.2 per cent and 29.5 per cent of the patients were referred by otorhinolaryngologists and internists, respectively. The cause of vertigo or dizziness and diagnosis was missing in 47.0 per cent of the reference letters. In addition, 67.3 per cent of the diagnoses by previous physicians differed from those reported by specialised neurotologists.ConclusionTo ensure patient satisfaction and high quality of life, an accurate diagnosis for vertigo or dizziness is required; therefore, methods or materials to improve the diagnostic accuracy are needed.

scholarly journals Systematic review protocol examining the effects of introducing pay-for-performance for primary care physicians on diabetes outcomes in single-payer healthcare systems (Preprint)

2018 ◽  
Author(s):  
Neeru Gupta
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Diabetes Care ◽  
Primary Care Physicians ◽  
Pay For Performance ◽  
Unintended Consequences ◽  
Research Database ◽  
Diabetes Outcomes ◽  
Single Payer ◽  
Wide Range

BACKGROUND Although pay-for-performance (P4P) for diabetes care is increasingly common across health organizations, evidence of its effectiveness in improving population health and service delivery is deficient. This information gap is attributable in part to the heterogeneity of healthcare financing, covered medical conditions, care settings, and provider remuneration arrangements within and across countries. OBJECTIVE This paper outlines a protocol for a systematic review examining the effects of introducing P4P for physicians in primary care and community settings to support guideline-based diabetes care. Our aim is to reduce the heterogeneity of evidence presented that has deterred conclusiveness of previous reviews by narrowing the focus to disease-specific P4P schemes in single-payer healthcare insurance systems. This approach enables us to minimize the risk of unintended consequences of P4P such as physicians’ gaming the payment system. METHODS Our review systematically searches, appraises, and synthesizes the literature concentrating on whether P4P for primary care physicians leads to better diabetes outcomes in single-payer health systems. We search 10 electronic databases and manually scan the reference lists of review articles and other global health literature. We include primary studies evaluating the effects of introducing P4P for diabetes care among primary care physicians in countries of universal health coverage. Outcomes of interest include patient morbidity, avoidable hospitalization, premature death, and healthcare costs. RESULTS We have received funding from Diabetes Canada and the New Brunswick Health Research Foundation to conduct policy-actionable diabetes health services research. Database searches were conducted and full-texts screened by two reviewers in 2017. We aim to submit the review for publication in 2018. CONCLUSIONS We are narratively synthesizing the data. Because of the wide range of outcomes considered, we do not expect to perform a meta-analysis. Since database searches were completed prior to the publication of this protocol, it is ineligible for registration with PROSPERO.

Subjective Expected Utility and Referral Decisions in Obesity

1986 ◽  
Vol 25 (04) ◽  
pp. 215-221 ◽  
Author(s):  
P. A. Jennett ◽  
A. S. Elstein ◽  
Marilyn Rothert ◽  
D. R. Rovner ◽  
Necia Black
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Expected Utility ◽  
Primary Care Physicians ◽  
Subjective Expected Utility ◽  
Value Assessment ◽  
Subjective Probabilities ◽  
Adequate Model ◽  
Referral Decisions ◽  
Patient Goals

SummaryReferral decisions of physicians dealing with long-term ambulatory problems are complex phenomena that are not clearly understood. This study was designed to assess the possible rationale behind such decisions in the management of obesity. It examined how well a subjective expected utility (SEU) model accounted for decisions of 45 primary care physicians regarding referral of obese female patients to an endocrinologist. Two patient goals, weight reduction and patient satisfaction, and a two-year time horizon were incorporated in the model.Data were collected using 24 written cases representing 12 patients approximately 100% overweight and 12 about 50% overweight, and a semi-structured interview in which subjective probabilities and importance weights were obtained. Values were calculated by transforming physicians’ ratings of risk of morbidity in the 24 cases into a utility scale.The SEU did not account for the primary care physicians’ referral behavior. Correlations between number of patient cases referred and SEU were analyzed and were not statistically significant, although there was substantial variation across physicians in number of cases referred. Mean subjective probabilities of weight loss and patient satisfaction were essentially identical for referral and non-referral.The formulation of the model, the design of the cases, and the method of value assessment are discussed as potential threats to the validity of the model as an account of referral decisions. Problems of constructing an adequate model are considered.

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