A recent study in healthcare is shedding light on whether employees respond more strongly to real-time performance feedback alone or when such feedback is combined with financial incentives - yielding some surprising insights.
Healthcare organisations are under increasing pressure to improve the standard of primary care while operating within constrained budgets. What do you do when the money runs out, but standards of care need to improve?
Dr Gabriel Facchini collaborated with the Catalan Health Institute (ICS) and other institutions to explore what kind of incentives lead to performance improvement in primary healthcare. They compared the effects of financial incentives versus providing performance-based feedback to see whether information alone is a good motivator.
“Both informing and incentivising indicators are powerful tools for improving the quality of primary care and reducing practice variability. By standardising processes and incentives across the region patients could receive the same quality of care regardless of where they are treated.”
The results published in this recent paper revealed that, while information feedback and financial incentivisation generally led to better standard of care, using information provision alone can sometimes match or even surpass the impact of financial motivators.
The study analysed a decade of data from the ICS's information and incentive schemes, across 272 primary care practices, with an average of over five million registered patients per year. It looked at quality-of-care EQA indicator results and variability of results and selected indicators which fell into two groups: the provision of real-time information to ICS healthcare professionals through an online platform, and those that were informed plus economically incentivised to achieve certain quality objectives.
| "The results suggest that providing more feedback and concentrating rewards on targeted indicators could achieve greater results. This indicates that providing physicians with more feedback could be a cost-efficient way to improve the standard of primary care, rather than increasing financial incentives.” |
These results can help healthcare policymakers to decide where to invest their budgets. The success of the online reporting platform highlights the importance of effective information systems that deliver clear and easily accessible performance data. This work is part of Flash Project, a European Union Horizon-funded initiative aimed at examining and improving healthcare financing models.
This study raises crucial questions for future research in healthcare quality improvement. Dr Facchini believes that further research into the specific indicators driving performance would help understand what would happen if there were more targets. “How much information can you give healthcare professionals until it is too much that they don't know what to focus on? If you incentivise everything, then nothing will change. The challenge is to work out the right number of indicators to motivate and drive performance. These insights could significantly enhance cost-efficiency and guide policy-making decisions.”
------------------------------------------------------------
Affiliations:
Roger Esteban-Fabró Ermengol Coma Eduardo Hermosilla Leonardo Méndez-Boo Carolina Guiriguet Catia Nicodemo Josep Vidal-Alaball
