Ettner S; TRIAD Physician Incentives Writing Group; AcademyHealth. Meeting (2003 : Nashville, Tenn.).
Abstr AcademyHealth Meet. 2003; 20: abstract no. 764.
UCLA, Medicine, 91, Los Angeles, CA 90095 Tel. (310) 794-2289 Fax (310) 794-0732
RESEARCH OBJECTIVE: To examine the associations of physician reimbursement incentives with quality of care. STUDY DESIGN: Translating Research into Action for Diabetes (TRIAD) is a 6-center study of 11,921 persons with diabetes from 56 provider groups and ten health plans (response rate 69%). Data were obtained from patient survey and medical record review. Quality indicators included glycemic control (HbA1c) assessment; lipid profile assessment; proteinuria assessment; receipt of dilated eye exam; receipt of foot exam most or all visits; advice to take aspirin; and receipt of a flu shot. In preliminary analyses, measures of physician reimbursement incentives included the percentage of the primary care provider's salary that depends on: quality and patient satisfaction, inpatient utilization and costs, and outpatient utilization and costs; provider group capitation experience; whether any part of the specialty physician's salary was capitated; and whether vision care was carved out. We estimated multi-level logistic regressions with random health plan and provider group intercepts.The models included measures of physician reimbursement incentives, sex, race, Latino ethnicity, age, education and income categories, diabetes treatment type, years since diabetes diagnosis, PCS and MCS scores, and a cardiovascular comorbidity score. POPULATION STUDIED: 11,921 persons with diabetes from 56 provider groups and ten health plans. PRINCIPAL FINDINGS: In preliminary analyses, no strong findings emerged. Only two of the odds ratios associated with provider financial incentives were significant at the 5% level, and this is likely due to multiple comparisons. CONCLUSIONS: Physician reimbursement incentives do not appear to explain variation in the quality of diabetes care provided to managed care patients. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Provider groups are unlikely to greatly improve the quality of diabetes care by financially incentivizing physicians.
Publication Types:
Keywords:
- Diabetes Mellitus
- Diabetes Mellitus, Type 2
- Health Maintenance Organizations
- Humans
- Income
- Managed Care Programs
- Motivation
- Patient Satisfaction
- Physicians
- Quality Indicators, Health Care
- Salaries and Fringe Benefits
- economics
- hsrmtgs
Other ID:
UI: 102275732
From Meeting Abstracts