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Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol

Hocking, Jane S, Temple-Smith, Meredith, van Driel, Mieke, Law, Matthew, Guy, Rebecca, Bulfone, Liliana, Wood, Anna, Low, Nicola, Donovan, Basil, Fairley, Christopher K, Kaldor, John and Gunn, Jane 2016, Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol, Implementation science, vol. 11, pp. 1-7, doi: 10.1186/s13012-016-0489-0.

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Title Can preventive care activities in general practice be sustained when financial incentives and external audit plus feedback are removed? ACCEPt-able: a cluster randomised controlled trial protocol
Author(s) Hocking, Jane S
Temple-Smith, Meredith
van Driel, Mieke
Law, Matthew
Guy, Rebecca
Bulfone, LilianaORCID iD for Bulfone, Liliana orcid.org/0000-0001-6406-5231
Wood, Anna
Low, Nicola
Donovan, Basil
Fairley, Christopher K
Kaldor, John
Gunn, Jane
Journal name Implementation science
Volume number 11
Article ID 122
Start page 1
End page 7
Total pages 7
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016
ISSN 1748-5908
1748-5908
Keyword(s) Audit and feedback
Cluster randomised controlled trial
Financial incentives
Preventive care
Primary care
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
Summary Background
Financial incentives and audit plus feedback on performance are two strategies commonly used by governments to motivate general practitioners (GP) to undertake specific healthcare activities. However, in recent years, governments have reduced or removed incentive payments without evidence of the potential impact on GP behaviour and patient outcomes. This trial (known as ACCEPt-able) aims to determine whether preventive care activities in general practice are sustained when financial incentives and/or external audit plus feedback on preventive care activities are removed. The activity investigated is annual chlamydia testing for 16- to 29-year-old adults, a key preventive health strategy within this age group.

Methods/design

ACCEPt-able builds on a large cluster randomised controlled trial (RCT) that evaluated a 3-year chlamydia testing intervention in general practice. GPs were provided with a support package to facilitate annual chlamydia testing of all sexually active 16- to 29-year-old patients. This package included financial incentive payments to the GP for each chlamydia test conducted and external audit plus feedback on each GP’s chlamydia testing rates. ACCEPt-able is a factorial cluster RCT in which general practices are randomised to one of four groups: (i) removal of audit plus feedback—continue to receive financial incentive payments for each chlamydia test; (ii) removal of financial incentive payments—continue to receive audit plus feedback; (iii) removal of financial incentive payments and audit plus feedback; and (iv) continue financial incentive payments and audit plus feedback. The primary outcome is chlamydia testing rate measured as the proportion of sexually active 16- to 29-year-olds who have a GP consultation within a 12-month period and at least one chlamydia test.

Discussion

This will be the first RCT to examine the impact of removal of financial incentive payments and audit plus feedback on the chlamydia testing behaviour of GPs. This trial is particularly timely and will increase our understanding about the impact of financial incentives and audit plus feedback on GP behaviour when governments are looking for opportunities to control healthcare budgets and maximise clinical outcomes for money spent. The results of this trial will have implications for supporting preventive health measures beyond the content area of chlamydia.
Language eng
DOI 10.1186/s13012-016-0489-0
Field of Research 111799 Public Health and Health Services not elsewhere classified
11 Medical And Health Sciences
08 Information And Computing Sciences
Socio Economic Objective 0 Not Applicable
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30096164

Document type: Journal Article
Collections: Faculty of Health
Population Health
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.