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Strengthen the Evidence for Maternal and Child Health Programs

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Displaying records 1 through 3 (3 total).

Kaczorowski J, Hearps SJ, Lohfield L, et al. Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates. Can Fam Physician. 2013;59(6):e282-9. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Financial Incentives, Nurse/Nurse Practitioner
Intervention Description: Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.
Primary Outcomes: Rate of Pap smear delivery, defined as the number of women in each practice that were up-to-date with screening divided by all eligible women
Conclusion: The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.
Study Design: Total (N=246) Analysis (n=232) N=physicians
Significant Findings: Yes
Setting: Eight primary care network practices and 16 family health network practices in southwestern Ontario
Target Audience: Practicing physicians from the participating primary care network and family health network groups
Data Source: CytoBase (consortium of main laboratories in Ontario), combined with rosters of eligible patients
Age Range: N/A

Rosenthal MB, Frank RG, Li Z, Epstein AM. Early experience with pay-for-performance: from concept to practice. JAMA. 2005;294(14):1788-93. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Financial Incentives
Intervention Description: The study evaluated a natural experiment with pay-for-performance using administrative reports of physician group quality from a large health plan for an intervention group (California physician groups) and a contemporaneous comparison group (Pacific Northwest physician groups). Quality improvement reports were included from October 2001 through April 2004 issued to approximately 300 large physician organizations. Main outcome measures: Three process measures of clinical quality: cervical cancer screening, mammography, and hemoglobin A1c testing.
Primary Outcomes: Health care Effectiveness Data and Information Set (HEDIS) cervical cancer measure
Conclusion: Paying clinicians to reach a common, fixed performance target may produce little gain in quality for the money spent and will largely reward those with higher performance at baseline.
Study Design: QE: pretest-posttest non-equivalent control group
Setting: PacifiCare medical groups in California and the Pacific Northwest
Target Audience: Physician groups
Data Source: PacifiCare physician group performance reports
Sample Size: Intervention (n=163); Control (n=42) N=physician groups
Age Range: N/A

Gavagan TF, Du H, Saver BG, et al. Effect of financial incentives on improvement in medical quality indicators for primary care. J Am Board Fam Med. 2010;23(5):622-31. Access Abstract

NPM: 1: Well-Woman Visit
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Financial Incentives
Intervention Description: A retrospective review of administrative data was done to evaluate a natural quasi-experiment in a network of publicly funded primary care clinics. Physicians in 6 of 11 clinics were given a financial incentive twice the size of the current Centers for Medicare and Medicaid Services' incentive for achieving group targets in preventive care that included cervical cancer screening, mammography, and pediatric immunization. They also received productivity incentives. Six years of performance indicators were compared between incentivized and nonincentivized clinics. We also surveyed the incentivized clinicians about their perception of the incentive program.
Primary Outcomes: Proportion of Pap tests performed monthly at each clinic
Conclusion: We found no evidence for a clinically significant effect of financial incentives on performance of preventive care in these community health centers. Based on our findings and others, we believe there is great need for more research with strong research designs to determine the effects, both positive and negative, of financial incentives on clinical quality indicators in primary care.
Study Design: QE: concurrent comparison group
Setting: Eleven safety-net community health centers in Houston/Harris County, TX (Community Health Program [CHP])
Target Audience: Practicing CHP physicians
Data Source: Chart review
Sample Size: Approximate total (N≈110) N=physicians Total (N=12,495) Intervention (n=7,411); Control (n=5,084) N=charts reviewed
Age Range: N/A

   

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.