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Pay for performance scheme for general practitioners in France: results in 2018

Title: Pay for performance scheme for general practitioners in France: results in 2018
Authors: Atramont, A A; Coffy, S C; Sebo, S S; Debeugny, G D
Source: European Journal of Public Health ; volume 29, issue Supplement_4 ; ISSN 1101-1262 1464-360X
Publisher Information: Oxford University Press (OUP)
Publication Year: 2019
Description: Methods A pay-for-performance scheme, known as Remuneration on public health objectives (ROSP) and based on meeting targets on quality and efficiency indicators, was introduced for general practitioners in France in 2012. Since 2017, following the 2016 medical agreement between Health Insurance and doctors’ unions, ROSP has consisted of 29 indicators: 8 about chronic disease management, 12 about prevention and 9 about appropriate and efficient prescriptions. The aim of this work was to describe the 2018 results and the overall evolution of the indicators for office-based practitioners. Data are from the French national health system database. Results Follow-up of diabetic patients is steady: diabetic retinopathy screening and regular HbA1c measurement have been performed in 63% and 79% of them since 2016, respectively. Screening for chronic kidney disease improved for diabetic patients (29% in 2015 to 39% in 2018) and hypertensive patients (6% to 11%) but remain low. Influenza vaccination among people over 65 years increased in 2018 (55%) while a downward trend has been observed since 2011 (58% in 2011, 53% in 2016). The number of antibiotic treatments has decreased since 2011, from 46 out of 100 adults without long-term disease to 36 in 2018. In contrast, breast cancer and cervical cancer screening indicators have stagnated for several years around 66% and 56%, respectively. In terms of efficiency, all the indicators improved, most of them consisting in biosimilar and generic drugs prescription. By 2018, ROSP represents 3% of doctors’ revenue (including fee-for-service and lump sum payments). Conclusions By promoting prevention, better management of chronic diseases and optimizing prescriptions in relation to standards, ROSP indicators contribute to improve medical practices. The indicators need to be regularly updated to take into account the evolution of practices and recommendations. Key messages By promoting prevention, better management of chronic diseases and optimizing prescriptions in relation ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurpub/ckz187.147
Availability: https://doi.org/10.1093/eurpub/ckz187.147; http://academic.oup.com/eurpub/article-pdf/29/Supplement_4/ckz187.147/32630092/ckz187.147.pdf
Rights: https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model
Accession Number: edsbas.471F707C
Database: BASE