The Role of GP’s Compensation Schemes in Diabetes Care: Evidence from Panel Data

Quaderni DSE Working Paper No. 766

36 Pages Posted: 27 Jun 2011

See all articles by Elisa Lezzi

Elisa Lezzi

University of Bologna - School of Economics, Management, and Statistics

Matteo Lippi Bruni

University of Bologna - Department of Economics

Cristina Ugolini

University of Bologna - Department of Economics

Date Written: June 27, 2011

Abstract

The design of incentive schemes that improve quality of care is a central issue for the healthcare sector. Nowadays we observe many pay-for-performance programs, where payment is contingent on meeting indicators of provider effort, but also other alternative strategies have been introduced, for example programs rewarding physicians for participation in diseases management plans. Although it has been recognised that incentive-based remuneration schemes can have an impact on GP behaviour, there is still weak empirical evidence on the extent to which such programs influence health outcomes.

We investigate the impact of financial incentives in Regional and Local Health Authority contracts for primary care in the Italian Region Emilia Romagna for the years 2003-05. We focus on avoidable hospitalisations (Ambulatory Care Sensitive Conditions) for patients affected by type 2 diabetes mellitus, for which the assumption of responsibility and the adoption of clinical guidelines are specifically rewarded. We estimate a panel count data model using a Negative Binomial distribution to test the hypothesis that, other things equal, patients under the responsibility of GPs receiving a higher share of their income through these programs are less likely to experience avoidable hospitalisations.

Our findings support the hypothesis that financial transfers may contribute to improve quality of care, even when they are not based on the ex-post verification of performances.

Keywords: primary care, quality, diabetes, avoidable hospitalizations, panel count data models

JEL Classification: I11, I18, C31

Suggested Citation

Lezzi, Elisa and Lippi Bruni, Matteo and Ugolini, Cristina, The Role of GP’s Compensation Schemes in Diabetes Care: Evidence from Panel Data (June 27, 2011). Quaderni DSE Working Paper No. 766. Available at SSRN: https://ssrn.com/abstract=1873331 or http://dx.doi.org/10.2139/ssrn.1873331

Elisa Lezzi (Contact Author)

University of Bologna - School of Economics, Management, and Statistics ( email )

Piazza Scaravilli 1
40126 Bologna, fc 47100
Italy

Matteo Lippi Bruni

University of Bologna - Department of Economics ( email )

Piazza Scaravilli, 2
40126 Bologna, 40126
Italy

Cristina Ugolini

University of Bologna - Department of Economics ( email )

Piazza Scaravilli 2
Bologna, 40126
Italy

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