A voluntary key performance indicator for general practitioners increased the utilization of fixed-dose combination antihypertensives by an additional 0.98 percentage points (p=0.0003).
Cohort (n=2,522)
Yes
Does a voluntary key performance indicator linked to financial incentives increase the utilization of fixed-dose combination antihypertensives among general practitioners?
Linking financial incentives to a voluntary key performance indicator significantly increased the utilization of fixed-dose combination antihypertensives by general practitioners.
Mean Difference: 0.98
p-value: p=0.0003
Objective: In 2023, a health insurance company in Slovakia introduced a voluntary key performance indicator (vKPI) for general practitioners (GPs) aimed at increasing the use of fixed-dose combination (FDC) of antihypertensives. Meeting the vKPI led to higher reimbursement. The aim of this study was to assess the impact of vKPI on the FDC utilization among GPs. Design and method: We conducted a retrospective cohort study using administrative database of a health insurance company in Slovakia (1.77 mil. insurees in 2024) from 2019 to 2024. Each prescription of multiple antihypertensive medication classes by GPs was assessed for potential combination into an FDC. FDC utilization was compared among GPs who opted for vKPI and those who did not using difference-in-differences approach. Results: Data from 2,522 GPs were analyzed. Overall, FDC were utilized in 67.6% of 4,986,512 prescriptions. In 2023 and 2024, 24.7% of GPs opted for vKPI. Before vKPI introduction (2019-2022), GPs with vKPI had higher FDC use (on average by 2.11 percentage points, Figure) compared to those without vKPI, with parallel increasing trend. Following vKPI introduction (2023-2024), GPs with vKPI increased the utilization of FDC by an average of 0.98 percentage points additional to the previous trend (p = 0.0003).Conclusions: FDC utilization by GPs in Slovakia increased steadily between 2019 and 2024. The introduction of vKPI for FDC usage in GPs led to increased adoption of FDC. Linking financial incentives to FDC utilization appears to be an effective strategy for quality assessment, particularly in health insurance settings where clinical data are limited.
Selvek et al. (Fri,) conducted a cohort in Hypertension (n=2,522). Voluntary key performance indicator (vKPI) vs. No vKPI was evaluated on Fixed-dose combination (FDC) utilization (0.98 percentage points increase, p=0.0003). A voluntary key performance indicator for general practitioners increased the utilization of fixed-dose combination antihypertensives by an additional 0.98 percentage points (p=0.0003).