Incentive payments to British Columbia primary care physicians for chronic disease management: What is the effect on physician practice and patient care?

Project number: 
13-010
Approval date: 
Thursday, August 15, 2013
Principal Investigator: 
McGrail,Kimberlyn
Institution: 
Centre for Health Services and Policy Research (CHSPR)
Funding Agency: 
Canadian Institutes of Health Research(CIHR)
Datasets requested: 
PharmaNet
Medical Services Plan (BC Ministry of Health)
consolidation - census geocodes
ACG Case Mix Group (Johns Hopkins University)
Deaths (BC Vital Statistics Agency)
Consolidation registry (Ministry of Health)
College of Physicians and Surgeons of BC
Hospital Separations (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Research objective: 

Overall objective: We will study the impact of an incentive program for general practitioners on patterns of care, patient outcomes, and total costs.

Research question and hypotheses:
What effect have Chronic Care Annual Bonus and Complex Care Initiative payments had on: continuity of care; hospitalization rates; total cost per patient (GP, specialist, diagnostic, hospital and pharmacy); and disease specific quality indicators (for chronic disease incentives) among patients with qualifying chronic conditions?

Hypothesis 1: Continuity of care increases after the introduction of incentive payments.
Hypothesis 2: Provision of guideline-based care for specific conditions increases after the introduction of incentive payments.
Hypothesis 3: Hospitalization rates (overall admissions, admissions through the emergency department, and condition-specific admissions) decrease after the introduction of incentive payments.
Hypothesis 4: Total health care costs per patient (GP, specialist, diagnostic, hospital, and pharmacy) decrease after the introduction of incentive payments.

Secondary research questions will explore the characteristics of physicians who did and did not bill incentives, the patients for whom incentives were billed and the impact of incentive payments on treatment prevalence for qualifying chronic conditions.

Publications: 

Journal Publication

  • Lavergne MR, Law MR, Peterson S, Garrison S, Hurley J, Cheng L, McGrail KM. A population-based analysis of incentive payments to primary care physicians for the care of patients with complex disease. Canadian Medical Association Journal. 2016 Aug 15.

Conference abstract/presentation


Page last revised: December 5, 2017