Spillover effects of withdrawing quality incentives for primary care providers
Policy changes like financial incentives may have consequences for non-targeted patients and tasks because provision of their care involves the same inputs. Despite their importance for evaluating full consequences, such spillovers have been under-studied and often only mentioned as post hoc speculations for unexpected findings.
We consider how the removal of quality incentives for some tasks for patients with some health conditions in English primary care in 2014 and 2015 affected other patients and tasks. Using annual data from electronic health records of 1.1million patients registered with 800 practices between 2009 and 2017, we estimate direct and spillover effects of this incentive withdrawal using difference-in-differences regression. We consider six tasks and seven health conditions, providing several examples of incentives being withdrawn, maintained or never present. The direct effect of incentive withdrawal was a 18.6 percentage point (p.p.) reduction in task achievement. The within-patient spillover from incentive withdrawal was -3.1p.p. and the within-task spillover was +4.3p.p. Spillovers of policy changes may be substantial and should be an essential component of policy evaluations.
Speaker
Professor Matt Sutton (University of Manchester)Matt Sutton is a Professor of Health Economics and joint-lead of the Health Organisation, Policy and Economics (HOPE) research group at the University of Manchester, UK. He is a National Institute for Health and Care Research (NIHR) Senior Investigator, Deputy Director for the NIHR Applied Research Collaboration Greater Manchester, co-Director of the Department of Health and Social Care Policy Research Unit in Health and Social Care Systems and Commissioning, and an Honorary Professorial Fellow at the University of Melbourne. He received his MSc and his PhD in Health Economics from the University of York. He is an expert in policy evaluation and applied econometrics with 29 years’ experience as an academic health economist and two years’ experience as a government economist. He has over 250 publications in peer-reviewed journals including health economics journals, medical journals and economics journals. His research focuses on the organisation, financing and delivery of health care, health behaviours, and equity in health and healthcare. |
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CHE weekly seminar series
As part of the Centre for Health Economics’ vibrant research culture, we host a weekly seminar series. Visiting and invited researchers present current research relating to the economics of health and wellbeing, and the healthcare sector. Visitors are welcome to join these sessions where discussion and debate is encouraged. We aim to present all seminars in-person and also on Zoom.
Event Details
- Date:
- 16 November 2022 at 12:00 pm – 1:00 pm
- Venue:
- Caulfield campus, Building H, Level 9, Room H914
- Categories:
- CHE Seminar; General; Health Economics
Description
Policy changes like financial incentives may have consequences for non-targeted patients and tasks because provision of their care involves the same inputs. Despite their importance for evaluating full consequences, such spillovers have been under-studied and often only mentioned as post hoc speculations for unexpected findings.
We consider how the removal of quality incentives for some tasks for patients with some health conditions in English primary care in 2014 and 2015 affected other patients and tasks. Using annual data from electronic health records of 1.1million patients registered with 800 practices between 2009 and 2017, we estimate direct and spillover effects of this incentive withdrawal using difference-in-differences regression. We consider six tasks and seven health conditions, providing several examples of incentives being withdrawn, maintained or never present. The direct effect of incentive withdrawal was a 18.6 percentage point (p.p.) reduction in task achievement. The within-patient spillover from incentive withdrawal was -3.1p.p. and the within-task spillover was +4.3p.p. Spillovers of policy changes may be substantial and should be an essential component of policy evaluations.
Speaker
Professor Matt Sutton (University of Manchester)Matt Sutton is a Professor of Health Economics and joint-lead of the Health Organisation, Policy and Economics (HOPE) research group at the University of Manchester, UK. He is a National Institute for Health and Care Research (NIHR) Senior Investigator, Deputy Director for the NIHR Applied Research Collaboration Greater Manchester, co-Director of the Department of Health and Social Care Policy Research Unit in Health and Social Care Systems and Commissioning, and an Honorary Professorial Fellow at the University of Melbourne. He received his MSc and his PhD in Health Economics from the University of York. He is an expert in policy evaluation and applied econometrics with 29 years’ experience as an academic health economist and two years’ experience as a government economist. He has over 250 publications in peer-reviewed journals including health economics journals, medical journals and economics journals. His research focuses on the organisation, financing and delivery of health care, health behaviours, and equity in health and healthcare. |
|
CHE weekly seminar series
As part of the Centre for Health Economics’ vibrant research culture, we host a weekly seminar series. Visiting and invited researchers present current research relating to the economics of health and wellbeing, and the healthcare sector. Visitors are welcome to join these sessions where discussion and debate is encouraged. We aim to present all seminars in-person and also on Zoom.