IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v18y2017i5d10.1007_s10198-016-0813-2.html
   My bibliography  Save this article

Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data

Author

Listed:
  • Jonathan Sicsic

    (CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Hôpital Paul Brousse)

  • Carine Franc

    (CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Hôpital Paul Brousse)

Abstract

Background A voluntary-based pay-for-performance (P4P) program (the CAPI) aimed at general practitioners (GPs) was implemented in France in 2009. The program targeted prevention practices, including breast cancer screening, by offering a maximal amount of €245 for achieving a target screening rate among eligible women enrolled with the GP. Objective Our objective was to evaluate the impact of the French P4P program (CAPI) on the early detection of breast cancer among women between 50 and 74 years old. Methods Based on an administrative database of 50,752 women aged 50–74 years followed between 2007 and 2011, we estimated a difference-in-difference model of breast cancer screening uptake as a function of visit to a CAPI signatory referral GP, while controlling for both supply-side and demand-side determinants (e.g., sociodemographics, health and healthcare use). Results Breast cancer screening rates have not changed significantly since the P4P program implementation. Overall, visiting a CAPI signatory referral GP at least once in the pre-CAPI period increased the probability of undergoing breast cancer screening by 1.38 % [95 % CI (0.41–2.35 %)], but the effect was not significantly different following the implementation of the contract. Conclusion The French P4P program had a nonsignificant impact on breast cancer screening uptake. This result may reflect the fact that the low-powered incentives implemented in France through the CAPI might not provide sufficient leverage to generate better practices, thus inviting regulators to seek additional tools beyond P4P in the field of prevention and screening.

Suggested Citation

  • Jonathan Sicsic & Carine Franc, 2017. "Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 609-621, June.
    • Handle: RePEc:spr:eujhec:v:18:y:2017:i:5:d:10.1007_s10198-016-0813-2
    DOI: 10.1007/s10198-016-0813-2
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-016-0813-2
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10198-016-0813-2?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. repec:dau:papers:123456789/14771 is not listed on IDEAS
    2. Bruno S. Frey, 1997. "Not Just for the Money," Books, Edward Elgar Publishing, number 1183.
    3. Mousquès, Julien & Renaud, Thomas & Scemama, Olivier, 2010. "Is the "practice style" hypothesis relevant for general practitioners? An analysis of antibiotics prescription for acute rhinopharyngitis," Social Science & Medicine, Elsevier, vol. 70(8), pages 1176-1184, April.
    4. Sicsic, Jonathan & Le Vaillant, Marc & Franc, Carine, 2012. "Intrinsic and extrinsic motivations in primary care: An explanatory study among French general practitioners," Health Policy, Elsevier, vol. 108(2), pages 140-148.
    5. Roland Bénabou & Jean Tirole, 2003. "Intrinsic and Extrinsic Motivation," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 70(3), pages 489-520.
    6. repec:dau:papers:123456789/14768 is not listed on IDEAS
    7. Jinhu Li & Jeremiah Hurley & Philip DeCicca & Gioia Buckley, 2014. "Physician Response To Pay‐For‐Performance: Evidence From A Natural Experiment," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 962-978, August.
    8. Eijkenaar, Frank & Emmert, Martin & Scheppach, Manfred & Schöffski, Oliver, 2013. "Effects of pay for performance in health care: A systematic review of systematic reviews," Health Policy, Elsevier, vol. 110(2), pages 115-130.
    9. Vincenzo Carrieri & Marcel Bilger, 2013. "Preventive care: underused even when free. Is there something else at work?," Applied Economics, Taylor & Francis Journals, vol. 45(2), pages 239-253, January.
    10. Kathleen J. Mullen & Richard G. Frank & Meredith B. Rosenthal, 2010. "Can you get what you pay for? Pay‐for‐performance and the quality of healthcare providers," RAND Journal of Economics, RAND Corporation, vol. 41(1), pages 64-91, March.
    11. Holmstrom, Bengt & Milgrom, Paul, 1991. "Multitask Principal-Agent Analyses: Incentive Contracts, Asset Ownership, and Job Design," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 7(0), pages 24-52, Special I.
    12. repec:dau:papers:123456789/14982 is not listed on IDEAS
    13. Scott, Anthony, 2001. "Eliciting GPs' preferences for pecuniary and non-pecuniary job characteristics," Journal of Health Economics, Elsevier, vol. 20(3), pages 329-347, May.
    14. Carine Franc & Romain Lesur, 2004. "Systèmes de rémunération des médecins et incitations à la prévention," Revue économique, Presses de Sciences-Po, vol. 55(5), pages 901-922.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Gökkoca, Gökçe, 2024. "Antibiotic Stewardship in Primary Care: Evidence from Pay-for-Performance in France," TSE Working Papers 24-1567, Toulouse School of Economics (TSE).
    2. Nicolas da Silva, 2021. "The Industrialization of "Liberal Medicine" in France. A Labor Quality Conventions Approach," Post-Print hal-03185634, HAL.
    3. Nicolas da Silva, 2018. "La médecine libérale entre Sécurité sociale et capitalisme sanitaire : vers une prolétarisation du travail médical ?," Post-Print hal-02306254, HAL.
    4. Mauro, Marianna & Rotundo, Giorgia & Giancotti, Monica, 2019. "Effect of financial incentives on breast, cervical and colorectal cancer screening delivery rates: Results from a systematic literature review," Health Policy, Elsevier, vol. 123(12), pages 1210-1220.
    5. Monica Giancotti & Giorgia Rotundo & Paolo Misericordia & Silvestro Scotti & Milena Lopreite & Marianna Mauro, 2018. "Preliminary investigation into general practitioners? willingness to accept the pay-for-performance scheme: A replication study," MECOSAN, FrancoAngeli Editore, vol. 2018(106), pages 65-92.
    6. Sicsic, Jonathan & Krucien, Nicolas & Franc, Carine, 2016. "What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers," Social Science & Medicine, Elsevier, vol. 167(C), pages 116-127.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sicsic, Jonathan & Krucien, Nicolas & Franc, Carine, 2016. "What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers," Social Science & Medicine, Elsevier, vol. 167(C), pages 116-127.
    2. Panayotis Constantinou & Jonathan Sicsic & Carine Franc, 2017. "Effect of pay-for-performance on cervical cancer screening participation in France," International Journal of Health Economics and Management, Springer, vol. 17(2), pages 181-201, June.
    3. Lina Maria Ellegård, 2020. "Effects of pay-for-performance on prescription of hypertension drugs among public and private primary care providers in Sweden," International Journal of Health Economics and Management, Springer, vol. 20(3), pages 215-228, September.
    4. Claudia Keser & Emmanuel Peterlé & Cornelius Schnitzler, 2014. "Money talks - Paying physicians for performance," CIRANO Working Papers 2014s-41, CIRANO.
    5. Saint-Lary, Olivier & Sicsic, Jonathan, 2015. "Impact of a pay for performance programme on French GPs’ consultation length," Health Policy, Elsevier, vol. 119(4), pages 417-426.
    6. McCausland, David & Pouliakas, Konstantinos & Theodossiou, Ioannis, 2005. "Some are Punished and Some are Rewarded: A Study of the Impact of Performance Pay on Job Satisfaction," MPRA Paper 14243, University Library of Munich, Germany.
    7. Jeanne Lievaut & Philippe Batifoulier, 2011. "La transformation des actes gratuits en actes payants en médecine libérale. Une étude micro-économétrique longitudinale," EconomiX Working Papers 2011-12, University of Paris Nanterre, EconomiX.
    8. Ammi, Mehdi & Fortier, Grant, 2017. "The influence of welfare systems on pay-for-performance programs for general practitioners: A critical review," Social Science & Medicine, Elsevier, vol. 178(C), pages 157-166.
    9. Sun-Moon Jung & Jae Yong Shin, 2022. "Social Performance Incentives in Mission-Driven Firms," Management Science, INFORMS, vol. 68(10), pages 7631-7657, October.
    10. Maria Cotofan, 2019. "Learning from Praise: Evidence from a Field Experiment with Teachers," Tinbergen Institute Discussion Papers 19-082/V, Tinbergen Institute.
    11. Dirk Sliwka, 2007. "Trust as a Signal of a Social Norm and the Hidden Costs of Incentive Schemes," American Economic Review, American Economic Association, vol. 97(3), pages 999-1012, June.
    12. Galina Besstremyannaya & Sergei Golovan, 2019. "Physician’s altruism in incentive contracts: Medicare’s quality race," CINCH Working Paper Series 1903, Universitaet Duisburg-Essen, Competent in Competition and Health.
    13. Grant Miller & Kimberly Singer Babiarz, 2013. "Pay-for-Performance Incentives in Low- and Middle-Income Country Health Programs," NBER Working Papers 18932, National Bureau of Economic Research, Inc.
    14. repec:hal:spmain:info:hdl:2441/58ao15vh3t9tvakcshade02eov is not listed on IDEAS
    15. Sicsic, Jonathan & Le Vaillant, Marc & Franc, Carine, 2012. "Intrinsic and extrinsic motivations in primary care: An explanatory study among French general practitioners," Health Policy, Elsevier, vol. 108(2), pages 140-148.
    16. Timothy Besley & Maitreesh Ghatak, 2005. "Competition and Incentives with Motivated Agents," American Economic Review, American Economic Association, vol. 95(3), pages 616-636, June.
    17. J. Atsu Amegashie, 2009. "American Idol: should it be a singing contest or a popularity contest?," Journal of Cultural Economics, Springer;The Association for Cultural Economics International, vol. 33(4), pages 265-277, November.
    18. Brice Corgnet & Brian Gunia & Roberto Hernán González, 2021. "Harnessing the power of social incentives to curb shirking in teams," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 30(1), pages 139-167, February.
    19. Sliwka, Dirk, 2003. "On the Hidden Costs of Incentive Schemes," IZA Discussion Papers 844, Institute of Labor Economics (IZA).
    20. Brosig-Koch, Jeannette & Groß, Mona & Hennig-Schmidt, Heike & Kairies-Schwarz, Nadja & Wiesen, Daniel, 2021. "Physicians' incentives, patients' characteristics, and quality of care: A systematic experimental comparison of fee-for-service, capitation, and pay for performance," Ruhr Economic Papers 923, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    21. Delfgaauw, Josse & Dur, Robert, 2007. "Signaling and screening of workers' motivation," Journal of Economic Behavior & Organization, Elsevier, vol. 62(4), pages 605-624, April.

    More about this item

    Keywords

    Breast cancer screening; Difference-in-difference; Incentives; Pay for performance; Primary care;
    All these keywords.

    JEL classification:

    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:18:y:2017:i:5:d:10.1007_s10198-016-0813-2. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.