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The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines.
Prev Med. 2003 Mar; 36(3):291-9.PM

Abstract

BACKGROUND

This study tested the effects of two organizational support processes, the provision of financial incentives for superior clinical performance and the availability of a patient (smoker) registry and proactive telephone support system for smoking cessation, on provider adherence to accepted practice guidelines and associated patient outcomes.

METHODS

Forty clinics of a large multispecialty medical group practice providing primary care services were randomly allocated to study conditions. Fifteen clinics each were assigned to the experimental conditions "control" (distribution of printed versions of smoking cessation guidelines) and "incentive" (financial incentive pay-out for reaching preset clinical performance targets). Ten clinics were randomized to receive financial incentives combined with access to a centralized patient registry and intervention system ("registry"). Main outcome measures were adherence to smoking cessation clinical practice guidelines and patients' smoking cessation behaviors.

RESULTS

Patients' tobacco use status was statistically significant (P < 0.01) more frequently identified in clinics with the opportunity for incentives and access to a registry than in clinics in the control condition. Patients visiting registry clinics accessed counseling programs statistically significantly more often (P < 0.001) than patients receiving care in the control condition. Other endpoints did not statistically significantly differ between the experimental conditions.

CONCLUSIONS

The impact of financial incentives and a patient registry/intervention system in improving smoking cessation clinical practices and patient behaviors was mixed. Additional research is needed to identify conditions under which such organizational support processes result in significant health care quality improvement and warrant the investment.

Authors+Show Affiliations

National Committee for Quality Assurance, Washington, DC 20036, USA. roski@ncqa.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12634020

Citation

Roski, Joachim, et al. "The Impact of Financial Incentives and a Patient Registry On Preventive Care Quality: Increasing Provider Adherence to Evidence-based Smoking Cessation Practice Guidelines." Preventive Medicine, vol. 36, no. 3, 2003, pp. 291-9.
Roski J, Jeddeloh R, An L, et al. The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines. Prev Med. 2003;36(3):291-9.
Roski, J., Jeddeloh, R., An, L., Lando, H., Hannan, P., Hall, C., & Zhu, S. H. (2003). The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines. Preventive Medicine, 36(3), 291-9.
Roski J, et al. The Impact of Financial Incentives and a Patient Registry On Preventive Care Quality: Increasing Provider Adherence to Evidence-based Smoking Cessation Practice Guidelines. Prev Med. 2003;36(3):291-9. PubMed PMID: 12634020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines. AU - Roski,Joachim, AU - Jeddeloh,Robert, AU - An,Larry, AU - Lando,Harry, AU - Hannan,Peter, AU - Hall,Carmen, AU - Zhu,Shu-Hong, PY - 2003/3/14/pubmed PY - 2003/7/24/medline PY - 2003/3/14/entrez SP - 291 EP - 9 JF - Preventive medicine JO - Prev Med VL - 36 IS - 3 N2 - BACKGROUND: This study tested the effects of two organizational support processes, the provision of financial incentives for superior clinical performance and the availability of a patient (smoker) registry and proactive telephone support system for smoking cessation, on provider adherence to accepted practice guidelines and associated patient outcomes. METHODS: Forty clinics of a large multispecialty medical group practice providing primary care services were randomly allocated to study conditions. Fifteen clinics each were assigned to the experimental conditions "control" (distribution of printed versions of smoking cessation guidelines) and "incentive" (financial incentive pay-out for reaching preset clinical performance targets). Ten clinics were randomized to receive financial incentives combined with access to a centralized patient registry and intervention system ("registry"). Main outcome measures were adherence to smoking cessation clinical practice guidelines and patients' smoking cessation behaviors. RESULTS: Patients' tobacco use status was statistically significant (P < 0.01) more frequently identified in clinics with the opportunity for incentives and access to a registry than in clinics in the control condition. Patients visiting registry clinics accessed counseling programs statistically significantly more often (P < 0.001) than patients receiving care in the control condition. Other endpoints did not statistically significantly differ between the experimental conditions. CONCLUSIONS: The impact of financial incentives and a patient registry/intervention system in improving smoking cessation clinical practices and patient behaviors was mixed. Additional research is needed to identify conditions under which such organizational support processes result in significant health care quality improvement and warrant the investment. SN - 0091-7435 UR - https://www.unboundmedicine.com/medline/citation/12634020/The_impact_of_financial_incentives_and_a_patient_registry_on_preventive_care_quality:_increasing_provider_adherence_to_evidence_based_smoking_cessation_practice_guidelines_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S009174350200052X DB - PRIME DP - Unbound Medicine ER -