The Potential Role of Pay-for-Performance in Irish Health Care
There is insufficient evidence to support the introduction of pay-for-performance schemes in the Irish health-care system, according to a review of international evidence conducted by ESRI researchers. The new study concludes that pay-for-performance should not be considered at least until the many complexities in financial incentives in the current system are resolved.
In the context of the current fiscal crisis, securing greater value for money in health care is crucial. Pay-for-performance, in which GPs, hospitals and other providers are paid based on their achievement of defined quality and efficiency targets, is seen as a possible way to increase efficiency and value for money. Pay-for-performance schemes are being increasingly adopted internationally. The recent Programme for Government also includes commitments to reform the way in which GPs and public hospitals are paid. ESRI researchers examined pay-for-performance schemes operating in the US, UK, Australia and Germany, to see what lessons we might learn.
The study found that:
Commenting on the findings the authors note that "As the second largest component of public expenditure, health care is particularly vulnerable to the effects of the current fiscal crisis. International evidence highlights the importance of how we pay providers in health care, and pay-for-performance is now a common feature of many health-care systems. However, we find there is insufficient evidence of significant positive effects of current pay-for-performance initiatives in health care. On this basis, and in the context of an already-complex set of financial incentives in Irish health care, we conclude that pay-for-performance should not be considered at this time".
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Note to Editors:
(1) "The Potential Role of Pay-for-Performance in Irish Health Care" by Dr. Anne Nolan, Jacqueline O'Reilly, Dr. Samantha Smith and Dr. Aoife Brick is the 4th paper in a special series of ESRI studies that aims to survey available evidence to address issues related to Ireland's ongoing economic crisis. It will be published online on the ESRI website at 00:01 a.m. Wednesday 14 December. The embargo is until 00:01 a.m. Wednesday 14 December. A copy of this paper is available under embargo on request.
(2) A total of 12 studies are being undertaken as part of this “Renewal” project, which is supported by FBD Trust.
(3) The paper will be presented at a conference on improving public services to be held at the ESRI on the morning of Wednesday 14 December, which will also feature papers on what can be done to improve the quality of second-level education and how members of the public perceive the quality of Irish public services. Further information on the Conference is available on our website.
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