However, these studies involved low numbers of patients and they were carried out in high-level, specialized centers, which may introduce provider-related bias.
Indeed, it is not uncommon to see success rates improve over time when misoprostol is first introduced; providers who have not previously used misoprostol for treating incomplete abortion (or for medical abortion) need to become accustomed to the process, particularly the bleeding patterns, in order not to intervene prematurely.
The strategy of introducing provider networks in primary care in order to overcome a lack of coordination and continuity of care has been used in other health care systems, e.g. the health networks in France [ 35].
But in the current drive to introduce more providers into the system, our policymakers must not dilute the university brand – let's ensure that becoming a university remains a challenging process.
In the meanwhile, although great efforts were made to introduce alternative provider payment methods to FFS, it was less successful, particularly in a large scale.
During a 3-day visit to each facility, they oriented managers to SBM-R, introduced service providers to the tools and desired outcomes, and coached providers.
If this bias varies between providers, it can introduce misclassification on provider level and mislead pay-for-performance programs when better score on quality indicators is linked to financial incentives.
However, it's vital we continue to improve the service to claimants, which is why we are introducing new providers to increase capacity".
Since Germany's Renewable Energy Sources Act (EEG) was introduced 11 years ago, providers are guaranteed fixed prices for the electricity they feed into the grid.
Mark Hoban, minister for Employment, said: "Where our audits identify any drop in quality, we act decisively … It's vital we continue to improve the service to claimants, which is why we are introducing new providers to increase capacity".
