Exploring the effectiveness of a P4P scheme from the perspective of Italian general practitioners: A replication study.

A major problem of the primary healthcare system is the deficiency in performance quality. From the second half of the 20th century, many countries introduced pay for performance reimbursement schemes to encourage practitioner behaviour to align with specific objectives of decision-makers and to incentivise the provision of targeted services. The study of Krauth et al. (2016) provides key evidence from a European country, determining whether German general practitioners would participate in a pay for performance programme and under what conditions. Our research replicates this survey, adjusting it to the Italian context. We assessed the attitudes of Italian general practitioners towards the current remuneration scheme and analysed how such views varied among respondents. Results showed that the current remuneration scheme for Italian general practitioners does not seem to be proportional to the efforts given for the provision of care and does not provide appropriate incentives to supply high-quality healthcare. Most of respondents supported the introduction of a pay for performance remuneration system, although perceived potential obstacles. We conclude that for a successful implementation of a quality-based compensation scheme, GPs should be involved. Such participation would help better identify perceived obstacles and overcome them.