Can we incentivise improvements in child health? (Part 2)

In an earlier post, I entered a world of capitation, fee-for-service, block contracting and incentivisation, all ways of levering people to ‘do the right thing’, and ending by asking how to know what the ‘right thing’ was.

We could do this a number of ways – we can ask people; we can measure universally agreed ‘good’ things (mortality is a pretty strong candidate), or we could measure processes or surrogates. In primary care in the UK the current financial incentivisation scheme devotes 3% (yes – three) to children and young people; but a rather nice piece of work from Peter Gill and friends has come up with a series of other ‘measures’ that might be effective and meaningful and get things done even better.

The group garnered their raw potential measures from a series of well-conducted guidelines and then sieved them with a range of experts (expert in children in primary care and evidence-based practice) to develop 35 potentially routinely collectable items to place ‘incentives’ upon. For general practice, we’ve moderate evidence that financial incentives are effective when a condition is poorly managed, so it’s not a bad idea. Their lists included Mental health, ADHD, Asthma, Eczema, Epilepsy, Developmental assessment, Safeguarding issues, Obesity and Colic.

Now, they note:

The main weakness of the process was that the only stakeholders consulted were GPs.

How about using this blog, via comments, and perhaps an unscientific letter to follow-up their sterling work, to let them know what the wider child health community thinks about it?

– Bob Phillips


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