Ashworth Mark, Lea Robert, Gray Heather, Rowlands Gill, Gravelle Hugh, Majeed Azeem
GKT Department of General Practice and Primary Care, King's College London, 5 Lambeth Walk, London SE11 6SP.
J Public Health (Oxf). 2004 Mar;26(1):48-51. doi: 10.1093/pubmed/fdh100.
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.
英国的基层医疗组织（PCOs）被要求实施一项处方激励计划。目前尚不清楚全科医生（GPs）在这些计划下获得的平均报酬情况。我们对伦敦及英格兰东南部的所有PCOs进行了一项为期两年的纵向问卷调查研究，旨在探讨经济激励、处方指标的选择与预算控制成功之间的关系。在第二年，每位全科医生的平均奖励为1220英镑（范围为470英镑至4330英镑）。支出未超支的PCOs向其医疗机构支付的激励计划款项更多，那些成功将第一年的超支转变为第二年的未超支的PCOs也是如此。奖励的规模与任何基于成本或质量的特定处方指标的选择无关。我们得出结论，较大规模的处方激励计划款项可能有助于控制处方成本，但其对处方质量的影响尚不确定。
