Evidence map›Paper›PMID 41285514›Full record

SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2026

General practice incentives: a review of the international literature.

Mark Harris, Joel Rhee, Margo Barr, Anurag Sharma, Ben Harris-Roxas, Mary Burns, Kate Marshall, Rula Ali, Anthony P Sunjaya, Cathelijne van Kemenade and 1 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. How much evidence is needed before additional testing is incentivised at scale?The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mark HarrisFaculty of Medicine and Health, International Centre for Future Health Systems, University of New South Wales, Sydney, Australia.
Joel RheeFaculty of Medicine and Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Margo BarrFaculty of Medicine and Health, International Centre for Future Health Systems, University of New South Wales, Sydney, Australia margo.barr@unsw.edu.au.ORCID 0000-0002-3007-0216
Anurag SharmaFaculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, Australia.
Ben Harris-RoxasFaculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, Australia.
Mary BurnsFaculty of Medicine and Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Kate MarshallFaculty of Medicine and Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Rula AliFaculty of Medicine and Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Anthony P SunjayaFaculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, Australia.
Cathelijne van KemenadeEvaluation and Evidence Services, Sax Institute, Glebe, Australia.
Michael KiddFaculty of Medicine and Health, International Centre for Future Health Systems, University of New South Wales, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Australia, the general practice sector faces significant challenges, leading to a re-evaluation of its predominantly fee-for-service (FFS) funding models.

aimTo conduct a systematic review of reviews that evaluated the efficacy of funding models in general practice on quality outcomes in multidisciplinary primary and preventive care for people with complex chronic conditions, as well as the contextual factors that have influenced their implementation. DESIGN AND

settingOnly systematic reviews and meta-analyses were included. Search terms covered funding mechanisms, primary care, and general practice. The review followed PRISMA guidelines for systematic reviews.

methodPubMed, Cochrane, Embase, CINAHL, PsycInfo, PAIS, and Web of Science databases were searched in November 2023 for publications from 2010 onwards.

resultsTwenty reviews were included. Blended payment models incorporating pay-for-performance (P4P) with either capitation payments or FFS were associated with small improvements in quality outcomes, particularly in multidisciplinary settings. Changes in intermediate health outcomes and process measures for people with complex chronic conditions were most evident in diabetes care but inconclusive for other health outcomes and conditions. Improvements were mainly observed in incentivised activities and in less rigorously designed studies, with ceiling effects and variation reported across healthcare systems. There was no evidence that introducing capitation payments as part of blended payments improved quality of care.

conclusionAlthough blended payment models show promise, evidence for the effectiveness of models including P4P is highly variable. If adopted, careful evaluation of each incentive's impact on both quality and equity will be essential.

Indexed as

Fee-for-Service PlansGeneral PracticePrimary Health CareReimbursement, IncentiveAustraliaHumansgeneral practiceincentivesprimary health carereformresearch methodssystematic review

Identifiers

PMID41285514
PMCPMC13531530

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.