D6.3 – Report with empirical analysis of some of the incentives mapped in 6.2

Le résumé fourni par la source

Using data from Spain and Italy, this report provides evidence to enhance understanding of how information provision and financial incentives influence quality-of-care in the primary care sector.Long-term analyses (2010–2019) from the Catalan primary care system show that transparent, routinely updated feedback to professionals and financial incentives both contributed to improving quality-of-care and reducing practice variation. The benefits of information alone were similar to those of financial incentivisation, and adding incentivisation on top of information had a limited impact. Furthermore, derived indicators showed low responsiveness. These results underscore the need for careful design of quality improvement strategies.A second study, leveraging the staggered post-COVID reinstatement of financial incentives, demonstrates how these mechanisms operate after system shocks. Early reintroduction of incentives doubled the likelihood of returning to pre-pandemic performance in the first two years, although information alone still supported steady recovery. Recovery varied by indicator type and practice characteristics, confirming the importance of tailored approaches and highlighting a higher resilience among smaller and rural practices.Building on these findings, an ongoing prospective study tests the separate effects of withdrawing incentives and information on quality-of-care indicators. This will clarify whether information feedback can maintain quality in the absence of financial rewards and under which conditions performance declines.The analysis conducted on data from the Italian primary care setting assesses the causal impact of introducing financial incentives to improve the quality of electronic records of clinical information for patients with diabetes. We find that an incentive targeting the quality of information can improve care quality, as measured by how regularly diabetes is monitored through glycated haemoglobin testing.Overall, this report provides a number of insights for the design of incentives in the primary care setting. Information feedback is per se a powerful, scalable improvement tool, even in the absence of financial incentives; financial incentives add targeted value; in some cases, improvement in the quality of care can be achieved by providing incentives to improve the quality of health records; optimal quality-improvement schemes require strategic indicator selection, contextualization, and continuous performance monitoring.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.