Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care

Gregory M. Peterson; Grant Russell; Jan G. Radford; Nick Zwar; Danielle Mazza; Simon Eckermann; Judy Mullan; Marijka J. Batterham; Athena Hammond; Andrew Bonney

doi:10.1186/s12913-019-4336-2

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Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care

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Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care

Gregory M. Peterson, Grant Russell, Jan G. Radford, Nick Zwar, Danielle Mazza, Simon Eckermann, Judy Mullan, Marijka J. Batterham, Athena Hammond and Andrew Bonney

BMC health services research, Vol.19, 529

29/07/2019

DOI: https://doi.org/10.1186/s12913-019-4336-2

PMID: 31357999

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Abstract

Primary care

General practice

Quality

Continuity of care

Funding

Incentivisation

Health service utilisation

Background There is international interest in whether improved primary care, in particular for patients with chronic or complex conditions, can lead to decreased use of health resources and whether financial incentives help achieve this goal. This trial (EQuIP-GP) will investigate whether a funding model based upon targeted, continuous quality incentive payments for Australian general practices increases relational continuity of care, and lessens health-service utilisation, for high-risk patients and children. Methods We will use a mixed methods approach incorporating a two-arm pragmatic cluster randomised control trial with nested qualitative case studies. We aim to recruit 36 general practices from Practice-Based Research Networks (PBRN) covering urban and regional areas of Australia, randomised into intervention and control groups. Control practices will provide usual care while intervention practices will be supported to implement a new service model incorporating incentives for relational continuity and timely access to appointments. Patients will comprise three groups: older (over 65 years); 18–65 years with chronic and/or complex conditions; and those aged less than 16 years with increased risk of hospitalisation. The funding model includes financial incentives to general practitioners (GPs) for providing longer consultations, same day access and timely follow-up after hospitalisation to enrolled patients. The payments are proportional to expected health system savings associated with improved quality of GP care. An outreach facilitator will work with practices to help incorporate the incentive model into usual work. The main outcome measure is relational continuity of care (Primary Care Assessment Tool short-form survey), with secondary outcomes including health-related quality of life and health service use (hospitalisations, emergency presentations, GP and specialist services in the community, medicine prescriptions and targeted pathology and imaging ordering). Outcomes will be initially evaluated over a period of 12 months, with ongoing data collection for 5 years. Discussion The trial will provide robust evidence on a novel approach to providing continuous incentives for improving quality of general practice care, which can be compared to block payment incentives awarded at target quality levels of pay-for-performance, both within Australia and also internationally.

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Title: Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care
Creators: Gregory M. Peterson - University of Tasmania
Grant Russell - Monash University
Jan G. Radford - University of Tasmania
Nick Zwar - Bond University
Danielle Mazza - Monash University
Simon Eckermann - University of Wollongong
Judy Mullan - Illawarra Health and Medical Research Institute
Marijka J. Batterham - University of Wollongong
Athena Hammond - University of Wollongong
Andrew Bonney - University of Wollongong
Publication Details: BMC health services research, Vol.19, 529
Publisher: Springer Nature
Number of pages: 14
Grant note: Royal Australian College of General Practitioners (RACGP)
Identifiers: 991013154234802368
Copyright: © The Author(s). 2019, corrected publication [2019]. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Academic Unit: Faculty of Health
Language: English
Resource Type: Journal article

Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care

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