ArticleBMJ open2014
Perceptions and experiences of financial incentives: a qualitative study of dialysis care in England.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Factors influencing home dialysis choice in Scandinavia: a cross-sectional study.BMC nephrology · 2026Article
- Physician perspectives on the implications of the diagnosis-related groups for medical practice in Turkey: A qualitative study.The International journal of health planning and management · 2022Article
- Multidisciplinary staff attitudes to home haemodialysis therapy.Clinical kidney journal · 2017Article
- Factors affecting outcomes in patients reaching end-stage kidney disease worldwide: differences in access to renal replacement therapy, modality use, and haemodialysis practices.Lancet (London, England) · 2016Review
- Fracture clinic redesign reduces the cost of outpatient orthopaedic trauma care.Bone & joint research · 2016Article
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Authors and funding
5 authors.
Funding
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Abstract
objectiveThe objective of the study was to understand the extent to which financial incentives such as Payment by Results and other payment mechanisms motivate kidney centres in England to change their practices.
designThe study followed a qualitative design. Data collection involved 32 in-depth semistructured interviews with healthcare professionals and managers, focusing on their subjective experience of payment structures.
participantsParticipants were kidney healthcare professionals, clinical directors, kidney centre managers and finance managers. Healthcare commissioners from different parts of England were also interviewed.
settingParticipants worked at five kidney centres from across England. The selection was based on the prevalence of home haemodialysis, ranging from low (<3%), medium (5-8%) and high (>8%) prevalence, with at least one centre in each one of these categories at the time of selection.
resultsWhile the tariff for home haemodialysis is not a clear incentive for its adoption due to uncertainty about operational costs, Commissioning for Quality and Innovation (CQUIN) targets and the Best Practice Tariff for vascular access were seen by our case study centres as a motivator to change practices.
conclusionsThe impact of financial incentives designed at a policy level is influenced by the understanding of cost and benefits at the local operational level. In a situation where costs are unclear, incentives which are based on the improvement of profit margins have a smaller impact than incentives which provide an additional direct payment, even if this extra financial support is relatively small.
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