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Family doctor responses to changes in target stringency under financial incentives

Thursday 5 March 2020, 2.00PM to 3.00pm

Speaker(s): Luke Munford, Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester

Abstract: There is a risk that providers will engage in gaming if they self-report the targets on which they are monitored, regulated or rewarded. There is relatively little evidence on whether this occurs amongst health care providers. We examine how family doctors responded to a temporary but substantial increase in the stringency of the targets that governed their payments for ensuring patients diagnosed with hypertension had controlled blood pressure. We use patient-level data from 129 family practices over a seven-year period (2010 to 2016) to examine whether family doctors changed their diagnostic behaviour, increased treatment intensity, exempted patients, increased rates of testing and/or gamed the recording of the blood pressure measurements. There was some evidence of more intense treatment but also clear evidence of increased exemption of patients and bunching of recorded measurements just under the target level. These results suggest that doctors will game in response to changing performance targets under financial incentives.

Location: Room ARC/014, The Professor Alan Maynard Auditorium

Who to contact

For more information on these seminars, contact:

Maria Jose Aragon
Aimee Fox

If you are not a member of University of York staff and are interested in attending the seminar, please contact so that we can ensure we have sufficient space

CHE Seminar Programme

  • Thursday 5 March 
    Luke Munford, The University of Manchester
  • Thursday 2 April
    Katharina Hauck,
    Imperial College London
  • Monday 4 May
    Stirling Bryan, University of British Columbia
  • Friday 12 June
    Neil Davies, University of Bristol
  • Thursday 2 July
    Rachel Meacock, The University of Manchester
  • Thursday 3 September 
    Evan Kontopantelis, The University of Manchester
  • Thursday 1 October
    Werner Brouwer, Erasmus University Rotterdam
  • Thursday 5 November
    Marisa Miraldo,
    Imperial College
  • Thursday 3 December 
    Marie Sanderson, LSHTM

Map showing Location Details (PDF , 297kb)