Do family physicians need more payment for working better? Financial incentives in primary care

INTRODUCTION: Financial incentives are widely used in health services to improve the quality of care or to reach some specific targets. Pay for performance systems were also introduced in the primary health care systems of many European countries. OBJECTIVE: Our study aims to describe and compare recent existing primary care indicators and related financing in European countries. METHODS: Literature search was performed and questionnaires were sent to primary care experts of different countries within the European General Practice Research Network. RESULTS: Ten countries have published primary care quality indicators (QI) associated with financial incentives. The number of QI varies from 1 to 134 and can modify the finances of physicians with up to 25% of their total income. CONCLUSIONS: The implementations of these schemes should be critically evaluated with continuous monitoring at national or regional level; comparison is required between targets and their achievements, health gains and use of resources as well.