Featured Research

from universities, journals, and other organizations

Bonuses for doctors do little to improve cancer screening in Ontario

Date:
July 14, 2014
Source:
St. Michael's Hospital
Summary:
Ontario spent nearly $110 million dollars between 2006 and 2010 on bonuses to motivate family doctors to screen more of their patients for cancer but these bonuses were associated with little or no improvement in actual cancer screening rates, according to researchers. "Governments around the world are experimenting with paying doctors extra to improve the quality of care but there's actually very little evidence that this strategy works," said the lead author.

Ontario spent nearly $110 million dollars between 2006 and 2010 on bonuses to motivate family doctors to screen more of their patients for cancer but these bonuses were associated with little or no improvement in actual cancer screening rates, according to researchers at St. Michael's Hospital and the Institute for Clinical Evaluative Sciences (ICES).

The study, published today in Annals of Family Medicine, tracked screening rates for cervical, breast and colorectal cancer in Ontario each year between 2000 and 2010. Researchers found no significant changes in breast and cervical cancer screening rates after bonuses were introduced for doctors in 2006. The screening rate for colorectal cancer increased by 4.7 per cent per year after bonuses were introduced but it was already on the rise -- colorectal cancer screening was increasing by 3 per cent a year before the bonuses came into effect.

"Governments around the world are experimenting with paying doctors extra to improve the quality of care but there's actually very little evidence that this strategy works," said lead author Dr. Tara Kiran, a family physician and an associate scientist in the Li Ka Shing Knowledge Institute of St. Michael's Hospital.

Screening can catch cancer early and save lives. Pap tests screen for cervical cancer and mammograms are used to detect breast cancer. Colorectal cancer can be picked up by either a fecal occult blood test or a colonoscopy.

The amount doctors were paid varied based on the percentage of their appropriate patients -- determined by age and medical history -- who received the screening test. Physicians who had 60 per cent of their eligible patients screened for cervical cancer received $220 a year; the payment rose to $2,200 if 80 per cent were screened. In 2010, 84 per cent of eligible family doctors received at least one bonus payment and 22 per cent received the maximum bonus payment of $8,400 a year.

During the study period:

  • The screening rate for cervical cancer increased from 55 to 57 per cent
  • The screening rate for breast cancer increased from 60 to 63 per cent
  • The screening rate for colorectal cancer increased from 20 to 51 per cent

"Some alternatives to physician bonuses include targeted outreach by identifying under-screened populations and directly approaching patients," said Dr. Rick Glazier, a senior scientist at ICES and research director in the Department of Family and Community Medicine of St. Michael's Hospital. "Public advertising campaigns in Ontario have been associated with increased screening rates."

The researchers point to many reasons why breast and cervical cancer screening rates may not be improving. For example, many family doctors in Ontario may not have the tools they need to generate electronic reminders that can trigger screening. There also may be patients who decline screening due to misconceptions or because they don't have access to a female provider to perform their Pap test.


Story Source:

The above story is based on materials provided by St. Michael's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. T. Kiran, A. S. Wilton, R. Moineddin, L. Paszat, R. H. Glazier. Effect of Payment Incentives on Cancer Screening in Ontario Primary Care. The Annals of Family Medicine, 2014; 12 (4): 317 DOI: 10.1370/afm.1664

Cite This Page:

St. Michael's Hospital. "Bonuses for doctors do little to improve cancer screening in Ontario." ScienceDaily. ScienceDaily, 14 July 2014. <www.sciencedaily.com/releases/2014/07/140714213636.htm>.
St. Michael's Hospital. (2014, July 14). Bonuses for doctors do little to improve cancer screening in Ontario. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2014/07/140714213636.htm
St. Michael's Hospital. "Bonuses for doctors do little to improve cancer screening in Ontario." ScienceDaily. www.sciencedaily.com/releases/2014/07/140714213636.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Cases Keep Coming for Monrovia's Island Hospital

Ebola Cases Keep Coming for Monrovia's Island Hospital

AFP (Oct. 1, 2014) A look inside Monrovia's Island Hospital, a key treatment centre in the fight against Ebola in Liberia's capital city. Duration: 00:34 Video provided by AFP
Powered by NewsLook.com
Ebola Puts Stress on Liberian Health Workers

Ebola Puts Stress on Liberian Health Workers

AP (Oct. 1, 2014) The Ebola outbreak is putting stress on first responders in Liberia. Ambulance drivers say they are struggling with chronic shortages of safety equipment and patients who don't want to go to the hospital. (Oct. 1) Video provided by AP
Powered by NewsLook.com
Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Newsy (Sep. 30, 2014) After the announcement that the first U.S. patient had been diagnosed with Ebola, doctors were quick to say a U.S. outbreak is highly unlikely. Video provided by Newsy
Powered by NewsLook.com
TX Hospital Confirms Patient Admitted With Ebola

TX Hospital Confirms Patient Admitted With Ebola

AP (Sep. 30, 2014) Medical officials from Texas Health Presbyterian Hospital confirm they are treating a patient with the Ebola virus, the first case found in the US. (Sept. 30 Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins