Moderating Effects of Patient Characteristics on the Impact of Financial Incentives
While financial incentives to providers or patients are increasingly common as a quality improvement strategy, their impact on patient subgroups and health care disparities is unclear. To examine these patterns, we analyzed data from a randomized clinical trial of financial incentives to lower low-d...
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Veröffentlicht in: | Medical care research and review 2019-02, Vol.76 (1), p.56-72 |
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Sprache: | eng |
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Zusammenfassung: | While financial incentives to providers or patients are increasingly common as a quality improvement strategy, their impact on patient subgroups and health care disparities is unclear. To examine these patterns, we analyzed data from a randomized clinical trial of financial incentives to lower low-density lipoprotein (LDL) cholesterol levels in patients at risk for cardiovascular disease. Patients with higher baseline LDL experienced greater cholesterol reductions in the shared incentive arm (0.23 mg/dL per unit change in baseline LDL, 95% CI [−0.46, −0.00]) but were also less likely to have medication potency increases in the physician incentive arm (OR = 0.98, 95% CI [0.97, 0.996]). Uninsured patients and those of race other than Black or White were less likely to have potency increases in the shared incentive arm (OR = 0.15, 95% CI [0.03, 0.70] and OR = 0.09, 95% CI [0.01, 0.93], respectively). These findings suggest some differential response to incentives, particularly in the form of targeted medication changes. |
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ISSN: | 1077-5587 1552-6801 1552-6801 |
DOI: | 10.1177/1077558717707313 |