Lighthouse Institute, Chestnut Health Systems, Normal, IL, USA.
Implement Sci. 2010 Jan 26;5:5. doi: 10.1186/1748-5908-5-5.
Rewarding provider performance has been recommended by the Institute of Medicine as an approach to improve the quality of treatment, yet little empirical research currently exists that has examined the effectiveness and cost-effectiveness of such approaches. The aim of this study is to test the effectiveness and cost-effectiveness of providing monetary incentives directly to therapists as a method to improve substance abuse treatment service delivery and subsequent client treatment outcomes.
Using a cluster randomized design, substance abuse treatment therapists from across 29 sites were assigned by site to either an implementation as usual (IAU) or pay-for-performance (P4P) condition.
Substance abuse treatment therapists participating in a large dissemination and implementation initiative funded by the Center for Substance Abuse Treatment.
Therapists in both conditions received comprehensive training and ongoing monitoring, coaching, and feedback. However, those in the P4P condition also were given the opportunity to earn monetary incentives for achieving two sets of measurable behaviors related to quality implementation of the treatment.
Effectiveness outcomes will focus on the impact of the monetary incentives to increase the proportion of adolescents who receive a targeted threshold level of treatment, months that therapists demonstrate monthly competency, and adolescents who are in recovery following treatment. Similarly, cost-effectiveness outcomes will focus on cost per adolescent receiving targeted threshold level of treatment, cost per month of demonstrated competence, and cost per adolescent in recovery.
NCT01016704.
医学研究所建议通过奖励提供者的绩效来改善治疗质量，但目前几乎没有实证研究来检验这种方法的有效性和成本效益。本研究旨在检验直接向治疗师提供金钱激励作为改善药物滥用治疗服务提供和随后的客户治疗结果的方法的有效性和成本效益。
使用集群随机设计，将来自 29 个地点的药物滥用治疗治疗师按照地点分配到实施常规（IAU）或按绩效付费（P4P）条件。
参与由药物滥用治疗中心资助的大型传播和实施计划的药物滥用治疗治疗师。
两种条件下的治疗师都接受了全面的培训和持续的监测、指导和反馈。然而，P4P 条件下的治疗师还有机会获得与治疗质量实施相关的两项可衡量行为的金钱奖励。
有效性结果将侧重于金钱奖励对增加接受目标阈值水平治疗的青少年比例、治疗师每月表现出的能力月数以及治疗后康复的青少年的影响。同样，成本效益结果将侧重于接受目标阈值水平治疗的每个青少年的成本、表现出能力的每个月的成本以及康复的每个青少年的成本。
NCT01016704。
