In 2004-5, achievement rates for incentivised indicators were significantly higher than rates projected from pre-incentive trends for all 17 measurement indicators, and five of the six prescribing indicators (table 3).
Achievement for these indicators reached a plateau after 2004-5, but quality of care in 2006-7 remained higher than that predicted by pre-incentive trends for 14 incentivised indicators.
There was no overall effect on the rate of improvement for non-incentivised indicators in the first year of the scheme, but by 2006-7 achievement rates were significantly below those predicted by pre-incentive trends.
By 2006-7 quality was significantly worse than projected from pre-incentive trends, most notably for measurement activities, and was also significantly below relative to projection the quality for incentivised activities.
The increase in achievement above that predicted from pre-incentive trends varied from 1.2% to 37.7%, with four indicators (all relating to measuring smoking status) having increases of over 30%.
Incentives had little impact on non-incentivised activities in the short term, but after three years quality of care for some fell significantly below levels predicted from pre-incentive trends Improvements associated with financial incentives seem to have been achieved at the expense of small detrimental effects on aspects of care that were not incentivised Cite this as: BMJ 2011 342 d3590.
Not significant under model 2. For the non-incentivised indicators, there were significant increases in achievement above the predicted rates for two of the nine measurement indicators, and a significant decrease for one (that is, achievement was below that predicted from pre-incentive trends).
‡Difference between observed achievement rate and rate projected from pre-incentive trend.
Using this approach we found that composite quality for patients with diabetes improved over and above the pre-incentive trend in the first post-intervention year, but by the third year improvement was smaller.
There's also a market-based incentive behind color trends: if a manufacturer makes last year's product in a new color, the product is perceived as new, and some consumers will feel the need to buy another one.
Beside the technological context that has made it possible, there is an economical and performance incentive for embracing the trend.
