The use of financial incentives in Australian general practice

Objective: To examine the uptake of financial incentive payments in general practice, and identify what types of practitioners are more likely to participate in these schemes. Design and setting: Analysis of data on general practitioners and GP registrars from the Medicine in Australia - Balancing Employment and Life (MABEL) longitudinal panel survey of medical practitioners in Australia, from 2008 to 2011. Main outcome measures: Income received by GPs from government incentive schemes and grants and factors associated with the likelihood of claiming such incentives. Results: Around half of GPs reported receiving income from financial incentives in 2008, and there was a small fall in this proportion by 2011. There was considerable movement into and out of the incentives schemes, with more GPs exiting than taking up grants and payments. GPs working in larger practices with greater administrative support, GPs practising in rural areas and those who were principals or partners in practices were more likely to use grants and incentive payments. Conclusions: Administrative support available to GPs appears to be an increasingly important predictor of incentive use, suggesting that the administrative burden of claiming incentives is large and not always worth the effort. It is, therefore, crucial to consider such costs (especially relative to the size of the payment) when designing incentive payments. As market conditions are also likely to influence participation in incentive schemes, the impact of incentives can change over time and these schemes should be reviewed regularly.