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一种与行为无关的经济激励措施对全科医生处方行为的影响。

Effects of a behaviour independent financial incentive on prescribing behaviour of general practitioners.

作者信息

Martens Jody D, Werkhoven Mirjam J, Severens Johan L, Winkens Ron A G

机构信息

Integrated Care Unit, and Department of Clinical Epidemiology and Medical Technology, University Hospital Maastricht, Maastricht, The Netherlands.

出版信息

J Eval Clin Pract. 2007 Jun;13(3):369-73. doi: 10.1111/j.1365-2753.2006.00707.x.

Abstract

RATIONALE AND OBJECTIVES

It is difficult to keep control over prescribing behaviour in general practice. The purpose of this study was to assess the initial effects of a behaviour independent financial incentive on the volume of drug prescribing of general practitioners (GPs).

DESIGN

2-Year Controlled Before After study with an intervention region and a concurrent control region.

SETTING AND PARTICIPANTS

GPs in two regions in the Netherlands (n = 119 and n = 118).

INTERVENTION

A financial incentive for prescribing according to local guidelines on specific drugs or drug categories. The financial incentive consisted of a non-recurrent, behaviour-independent allowance.

MAIN OUTCOME MEASURE

Change in the number of prescriptions for 10 targeted drugs or drug groups.

RESULTS

Significant changes were seen only in three types of antibiotics and in recommended gastric medicines. In almost all cases, effects were temporary.

CONCLUSION

Behaviour independent financial incentives can be a help in changing prescription behaviour of GPs, but effects are small-scale and temporary.

摘要

原理与目的

在全科医疗中,难以对处方行为进行控制。本研究的目的是评估一种与行为无关的经济激励措施对全科医生(GP)药物处方量的初始影响。

设计

一项为期两年的干预前后对照研究,设有一个干预地区和一个同期对照地区。

地点与参与者

荷兰两个地区的全科医生(分别为n = 119和n = 118)。

干预措施

根据当地关于特定药物或药物类别的指南进行处方的经济激励。该经济激励包括一次性、与行为无关的津贴。

主要观察指标

10种目标药物或药物组的处方数量变化。

结果

仅在三种抗生素和推荐的胃药中观察到显著变化。在几乎所有情况下,影响都是暂时的。

结论

与行为无关的经济激励措施有助于改变全科医生的处方行为,但效果规模小且是暂时的。

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