Faculty of Medicine, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Germany.
Master Program Medical Process Management, Universitätsklinikum Erlangen, Germany.
Am J Health Behav. 2023 Jun 30;47(3):458-470. doi: 10.5993/AJHB.47.3.3.
Healthcare expenditures in western countries have been rising for many years. This leads many countries to develop and test new reimbursement systems. A systematic review about monetary incentives in group settings indicated that a sole focus on monetary aspects does not necessarily result in better care at lower costs. Hence, this systematic review aims to describe the effects of non- monetary incentives in physician groups. We searched the databases MEDLINE (PubMed), The Cochrane Library, CINAHL, PsycINFO, EconLit, and ISI Web of Science. Grey literature search, reference lists, and authors' personal collection provided additional sources. Overall, we included 36 studies. We identified 4 categories of interventions related to non-monetary incentives. In particular, the category of decision support achieved promising results. However, design features vary among different decision support systems. To enable effective design, we provide an overview of the features applied by the studies included. Not every type of non-monetary incentive has a positive impact on quality of care in physician group settings. Thus, creating awareness among decision-makers regarding this matter and extending research on this topic can contribute to preventing implementation of ineffective incentives, and consequently, allocate resources towards tools that add value.
多年来，西方国家的医疗保健支出一直在不断上升。这导致许多国家开发和测试新的报销系统。一项关于团体环境中金钱激励的系统评价表明，单纯关注金钱方面并不一定会以更低的成本带来更好的护理。因此，本系统评价旨在描述医生群体中非金钱激励的效果。我们检索了 MEDLINE（PubMed）、The Cochrane Library、CINAHL、PsycINFO、EconLit 和 ISI Web of Science 数据库。灰色文献搜索、参考文献列表和作者的个人收藏提供了额外的来源。总的来说，我们纳入了 36 项研究。我们确定了与非金钱激励相关的 4 类干预措施。特别是，决策支持类别取得了有希望的结果。然而，不同的决策支持系统的设计特点各不相同。为了实现有效的设计，我们概述了所纳入研究中应用的特征。并非每种类型的非金钱激励都对医生群体环境中的护理质量有积极影响。因此，让决策者了解这一问题，并对这一主题进行研究，可以有助于防止实施无效的激励措施，从而将资源用于增加价值的工具。
