ArticlePloS one2013
Why did most French GPs choose not to join the voluntary national pay-for-performance program?
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.Journal of general internal medicine · 2016Pooled it
- Health Care Professionals' Perceptions of Pay-for-Performance in Practice: A Qualitative Metasynthesis.Inquiry : a journal of medical care organization, provision and financingPooled it
- The influence mechanism of psychological contract on primary medical staff's turnover intention in the context of COVID-19 pandemic in China.The International journal of health planning and management · 2022Article
- Awareness of, attitude toward, and willingness to participate in pay for performance programs among family physicians: a cross-sectional study.BMC family practice · 2020Article
- Heterogeneity in general practitioners' preferences for quality improvement programs: a choice experiment and policy simulation in France.Health economics review · 2016Article
- Understanding the nature of health: New perspectives for medicine and public health. Improved wellbeing at lower costs.F1000Research · 2016Article
- Patients' views on pay for performance in France: a qualitative study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- A comparison of HAS & NICE guidelines for the economic evaluation of health technologies in the context of their respective national health care systems and cultural environments.Journal of market access & health policy · 2015Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2009, a voluntary pay for performance (P4P) scheme for primary care physicians was introduced in France through the 'Contract for Improving Individual Practice' (CAPI). Although the contract could be interrupted at any time and without any penalty, two-thirds of French general practitioners chose not to participate. We studied what factors motivated general practitioners not to subscribe to the P4P contract, and particularly their perception of the ethical risks that may be associated with adhering to a CAPI.
methodA cross-sectional survey among French general practitioners using an online questionnaire based on focus group discussion results. Descriptive and multivariate statistical analyses with logistic regression.
resultsA sample of 1,016 respondents, representative of French GPs. The variables that were associated with the probability of not signing a CAPI were "discomfort that patients were not informed of the signing of a P4P contract by their doctors" (OR = 8.24, 95% CI = 4.61-14.71), "the risk of conflicts of interest" (OR = 4.50, 95% CI = 2.42-8.35), "perceptions by patients that doctors may risk breaching professional ethics" (OR = 4. 35, 95% CI = 2.43-7.80) and "the risk of excluding the poorest patients" (OR = 2.66, 95% CI = 1.53-4.63).
conclusionThe perception of ethical risks associated with P4P may have hampered its success. Although the CAPI was extended to all GPs in 2012, our results question the relevance of the program itself by shedding light on potential adverse effects.
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