Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-15T03:24:44.121Z Has data issue: false hasContentIssue false
  • English
  • Français

Incentivising improvements in health care delivery: a response to Adam Oliver

Published online by Cambridge University Press:  09 February 2015

Tim Doran
Tim Doran*
Affiliation:
Professor of Health Policy, University of York, Heslington, York, UK
*
*Correspondence to: Tim Doran, Professor of Health Policy, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK. Email: tim.doran@york.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Financial and reputational incentives are increasingly common components in strategies to performance manage the medical profession. Judging the impacts of incentives is challenging, however, and the science of framework design remains in its infancy. Oliver’s taxonomy therefore offers a useful and timely guide to the approaches that are most likely to be successful (and unsuccessful) in the field of health care. The use of incentives to date has focused on process measures and a narrow range of outcomes, a pragmatic approach that has produced some substantial quality gains within the constraints of existing health care systems. Improvement of specific technical aspects of quality may, however, have been achieved at the expense of trust, cooperation and benevolence. Deficits in these indispensible virtues will undermine any attempt to performance manage the medical and allied professions.

Type
Special Section
Information
Health Economics, Policy and Law , Volume 10 , Issue 3 , July 2015 , pp. 351 - 356
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Akerlof, G. and Kranton, R. (2010), ‘It is time to treat Wall Street like Main Street’, Financial Times, 24 February: 20.Google Scholar
Benedetti, F. (2009), Placebo Effects: Understanding the Mechanisms in Health and Disease, New York, NY: Oxford University Press.Google Scholar
Bevan, G. and Hood, C. (2006), ‘What’s measured is what matters: targets and gaming in the English public health system’, Public Administration, 84(3): 517–538.CrossRefGoogle Scholar
Chokshi, D. (2014), ‘Improving health care for veterans – a watershed moment for the VA’, New England Journal of Medicine, 371: 297–299.Google Scholar
Dawes, R., Faust, D. and Meehl, P. (1989), ‘Clinical versus actuarial judgment’, Science, 243: 1668–1674.CrossRefGoogle ScholarPubMed
Doran, T., Kontopantelis, E., Reeves, D., Sutton, M. and Ryan, A. (2014), ‘Setting performance targets in pay for performance programmes: what can we learn from QOF?’, BMJ, 348: g1595.CrossRefGoogle ScholarPubMed
Farmer, S., Black, B. and Bonow, R. (2013), ‘Tension between quality measurement, public quality reporting, and pay for performance’, The Journal of the American Medical Association, 309(4): 349–350.CrossRefGoogle ScholarPubMed
Francis, R. (2013), Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry HC 898 London: The Stationery Office, 2013.Google Scholar
Hamblin, R. (2007), ‘Publishing “quality” measures: how it works and when it does not?’, International Journal for Quality in Health Care, 19(4): 183–186.Google Scholar
Institute of Medicine (1999), To Err is Human: Building a Safer Health Care System, Washington, DC: National Academy Press.Google Scholar
Montgomery, K. (2004), How Doctors Think. Clinical Judgment and the Practice of Medicine, Oxford: Oxford University Press.Google Scholar
Morton, A. and Cornwell, J. (2009), ‘What’s the difference between a hospital and a bottling factory?’, BMJ, 339: b2727.Google Scholar
Oliver, A. (2015), ‘Incentivising improvements in health care delivery’, Monitor.Google Scholar
Oliver, A. and Brown, L. (2011), ‘Incentivizing professionals and patients: a consideration in the context of the United Kingdom and the United States’, Journal of Health Politics, Policy and Law, 36(1): 59–87.Google Scholar
Roland, M. (2012), ‘Pay-for-performance: not a magic bullet’, Annals of Internal Medicine, 157: 912–913.CrossRefGoogle Scholar
Ryan, A., Sutton, M. and Doran, T. (2014), ‘Does winning a pay-for-performance bonus improve subsequent quality performance? Evidence from the Hospital Quality Incentive Demonstration’, Health Services Research, 49(2): 568–587.CrossRefGoogle Scholar
The Shipman Inquiry (2004), ‘Fifth Report. Safeguarding Patients: Lessons from the Past – Proposals for the Future’, The Stationery Office, London, http://webarchive.nationalarchives.gov.uk/20090808154959/http://www.the-shipman-inquiry.org.uk/5r_page.asp?id=4552 [1 August 2014].Google Scholar
UK Clinical Aptitude Test (2014), ‘Situational Judgement’, http://www.ukcat.ac.uk/about-the-test/situational-judgement/ [25 August 2014].Google Scholar
Vladeck, B. (2004), ‘Ineffective approach’, Health Affairs, 23: 285–286.CrossRefGoogle ScholarPubMed