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澳大利亚全科医疗中使用经济激励措施。

The use of financial incentives in Australian general practice.

机构信息

University of Technology, Sydney, Sydney, NSW, Australia.

出版信息

Med J Aust. 2015 May 18;202(9):488-91. doi: 10.5694/mja14.00252.

Abstract

OBJECTIVE

To examine the uptake of financial incentive payments in general practice, and identify what types of practitioners are more likely to participate in these schemes.

DESIGN AND SETTING

Analysis of data on general practitioners and GP registrars from the Medicine in Australia - Balancing Employment and Life (MABEL) longitudinal panel survey of medical practitioners in Australia, from 2008 to 2011.

MAIN OUTCOME MEASURES

Income received by GPs from government incentive schemes and grants and factors associated with the likelihood of claiming such incentives.

RESULTS

Around half of GPs reported receiving income from financial incentives in 2008, and there was a small fall in this proportion by 2011. There was considerable movement into and out of the incentives schemes, with more GPs exiting than taking up grants and payments. GPs working in larger practices with greater administrative support, GPs practising in rural areas and those who were principals or partners in practices were more likely to use grants and incentive payments.

CONCLUSIONS

Administrative support available to GPs appears to be an increasingly important predictor of incentive use, suggesting that the administrative burden of claiming incentives is large and not always worth the effort. It is, therefore, crucial to consider such costs (especially relative to the size of the payment) when designing incentive payments. As market conditions are also likely to influence participation in incentive schemes, the impact of incentives can change over time and these schemes should be reviewed regularly.

摘要

目的

考察一般实践中对财务激励支付的接受情况,并确定哪些类型的从业者更有可能参与这些计划。

设计和设置

对澳大利亚医学 - 平衡就业与生活(MABEL)纵向医生小组调查的 2008 年至 2011 年期间一般医生和 GP 注册医生的数据进行分析。

主要观察指标

从政府激励计划和赠款中获得的 GP 收入,以及与申请此类激励措施的可能性相关的因素。

结果

约有一半的 GP 在 2008 年报告从财务激励中获得收入,到 2011 年,这一比例略有下降。激励计划的参与和退出比例相当大,退出激励计划的 GP 多于加入的 GP。在行政支持较大的大型实践中执业的 GP、在农村地区执业的 GP、以及实践中的负责人或合伙人更有可能使用赠款和激励支付。

结论

为 GP 提供的行政支持似乎是激励使用的一个越来越重要的预测因素,这表明申请激励的行政负担很大,并不总是值得的。因此,在设计激励支付时,必须考虑到这些成本(尤其是相对于支付金额的大小)。由于市场条件也可能影响激励计划的参与,激励的影响可能会随着时间的推移而变化,因此应定期审查这些计划。

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