The Tougher the Better: The Effect of an Increased Performance Threshold on the Performance of General Practitioners

OHE Research Paper No. 12/02

28 Pages Posted: 19 Aug 2015

See all articles by Yan Feng

Yan Feng

Office of Health Economics

Ada Ma

University of Aberdeen

Shelley Farrar

University of Aberdeen

Matt Sutton

The University of Manchester

Date Written: April 1, 2012

Abstract

This paper investigates whether and how a change in the performance-related payment scheme motivated General Practitioners (GPs) in Scotland. It evaluates the effect of increases in April 2006 in the performance thresholds required for maximum payment under the Quality and Outcomes Framework (QOF). A difference-in-differences estimator with fixed effects was employed to examine the number of patients treated under clinical indicators whose payment schedules were revised, and these were compared with the figures for those indicators whose schedules remained unchanged. The results suggest that the increase in the maximum performance thresholds improved GPs’ performance by 1.77% on average. Low-performing GPs improved significantly more (13.22%) than their high-performing counterparts (0.24%). Changes in maximum performance thresholds are differentially effective in incentivising GPs and could be used further to raise GPs’ performance across all indicators.

Suggested Citation

Feng, Yan and Ma, Ada and Farrar, Shelley and Sutton, Matt, The Tougher the Better: The Effect of an Increased Performance Threshold on the Performance of General Practitioners (April 1, 2012). OHE Research Paper No. 12/02, Available at SSRN: https://ssrn.com/abstract=2633475 or http://dx.doi.org/10.2139/ssrn.2633475

Yan Feng (Contact Author)

Office of Health Economics ( email )

Southside
105 Victoria Street
London, SW1E 6QT
United Kingdom

Ada Ma

University of Aberdeen ( email )

Dunbar Street
Aberdeen, Scotland AB24 3QY
United Kingdom

Shelley Farrar

University of Aberdeen ( email )

Dunbar Street
Aberdeen, Scotland AB24 3QY
United Kingdom

Matt Sutton

The University of Manchester ( email )

Oxford Road
Manchester, N/A M13 9PL
United Kingdom

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