The Effect of an Increase in the Rate of Payment on General Practitioners’ Intrinsic and Extrinsic Motivation

Abstract

This paper investigates how the increased rate of Quality and Outcomes Framework (QOF) payments implemented on 1 April 2005 affects Scottish general practitioners’ (GPs) intrinsic, extrinsic and overall motivation. A first difference method is used to model GPs’ intrinsic and overall motivation. GPs’ extrinsic motivation is modelled using a probit model and Mundlak approach. The main finding is that the increased QOF payment effectively motivated GPs’ health care supply, but it also crowded out GPs’ intrinsic motivation. The results suggests that using strong financial incentives to further motivate already well-motivated health care professionals may have unintended effects on their performance.