Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Incentives”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed2006

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools.

BACKGROUND: There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. METHODS: The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. RESULTS AND DISCUSSION: The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. CONCLUSION: The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their professionalism and addressing professional goals such as recognition, career development and further qualification. It must be the aim of human resources management/quality management (HRM/QM) to develop the work environment so that health workers are enabled to meet their personal and the organizational goals.

Journal Article↗
PubMed2006

Do the incentive payments in the new NHS contract for primary care reflect likely population health gains?

OBJECTIVE: The new contract for primary care in the UK offers fee-for-service (FFS) payments for a wide range of activities in a quality outcomes framework (QOF), with payments designed to reflect likely workload. This study aims to explore the link between these financial incentives and the likely population health gains. METHODS: The study examines a subset of eight preventive interventions covering 38 of the 81 clinical indicators in the quality framework. The maximum payment for each service was calculated and compared with the likely population health gain in terms of lives saved per 100,000 population based on evidence from McColl et al. (1998). RESULTS: Maximum payments for the eight interventions examined make up 57% of the total maximum payment for all clinical interventions in the (QOF). There appears to be no relationship between pay and health gain across these eight interventions. Two of the eight interventions (warfarin in atrial fibrillation and statins in primary prevention) receive no incentive. CONCLUSIONS: Payments in the new contract do not reflect likely population health gain. There is a danger that clinical activity may be skewed towards high-workload activities that are only marginally effective, to the detriment of more cost-effective activities. If improving population health is the primary goal of the NHS, then FFS incentives should be designed to reflect likely health gain rather than likely workload.

Fee-for-Service Plans↗
PubMed1988

Capitation and fee-for-service dental benefit plans: economic incentives, utilization, and service-mix.

Insurance carriers, corporations, and labor groups are actively developing and marketing dental capitation benefit plans. Incentives to both dentists and patients in these plans differ from those in the traditional fee-for-service system used with conventional benefit plans. This paper describes the likely effects of these incentive differences on utilization and service-mix patterns in both systems. Data for a large (approximately 10,000), homogenous group of subscribers are presented and discussed. Faced with a dual option, at no cost to the employee, 60% of the subscribers chose the fee-for-service plan, and 40% chose the capitation plan. Observed differences in the utilization and mix of services between the two plans cannot be explained solely in terms of dentists' responses. Employee response to altered economic incentives appears to be strong.

Capitation Fee↗
PubMed2005

Consolidation and reconsolidation of incentive learning in the amygdala.

Incentive learning is the process via which animals update changes in the value of rewards. Current evidence suggests that, for food rewards in rats, this learning process involves the amygdala. However, it remains unclear whether this learning undergoes protein synthesis-dependent consolidation and "reconsolidation" processes in the lateral and basal nuclei of amygdala. Accordingly, we examined this hypothesis by local infusion of protein-synthesis inhibitor after devaluation of a food reward induced by a shift from a food-deprived to a food-sated state in an instrumental conditioning paradigm. Our results show that intra-amygdala infusions of anisomycin, whether given after the initial devaluation or after a second devaluation session, abolished the changes in the value of the food reward produced by incentive learning. This study provides direct evidence that instrumental incentive learning depends on protein synthesis within the amygdala for both consolidation and reconsolidation and extends the demonstrations of protein synthesis-dependent reconsolidation to reward-related memories.

Amygdala↗
PubMedDate not supplied

Alternate financial incentives in multi-tiered formulary systems to improve accountability for outcomes.

BACKGROUND: Drug manufacturer rebates paid to health plans and pharmacy benefit management companies have come under increased public scrutiny. Over the past several years, numerous articles have appeared in the literature encouraging a shift to a more quality-based decision-making process for health plan drug formularies. OBJECTIVE: To propose a new basis for formulary placement decisions that would include consideration of health-plan-specific measures (clinical outcomes, total cost, adherence, and appropriateness of care) and align incentives for health plans, physicians, pharmacists, and pharmaceutical companies to promote high-quality care. SUMMARY: The proposed approach builds on key components of the Pharmacy's Framework for Drug Therapy Management in the 21st Century and the Academy of Managed Care Pharmacy's Format for Formulary Submission, including a focus on patient outcomes and evidence-based decision making. The proposed approach would lessen the influence of drug manufacturer rebates on formulary placement by shifting the focus to appropriateness of care, clinical outcomes, patient adherence, and total cost of care. Pharmaceutical manufacturers would benefit from the focus on adherence to drug therapy and total cost of care. Health plans and pharmacy benefit management companies would gain in that they may be able to reduce efforts in drug utilization review as pharmaceutical manufacturers are given incentives to market their drugs more appropriately. Physicians and pharmacists would benefit because the rebate money would be used to provide quality-based financial incentives related to adherence and appropriate use of drugs. CONCLUSION: The implementation of this approach would be difficult and require cooperation from employers, pharmacists, pharmaceutical manufacturers, health plans, and pharmacy benefit management companies. Aspects of this approach could be incorporated into existing pharmacy benefit management processes to encourage the delivery of high-quality health care.

Cyclooxygenase Inhibitors↗
PubMed2005

The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans.

This study evaluated the efficacy of adding contingency management techniques to vocational rehabilitation (VR) to improve treatment outcome as measured by entry into competitive employment. Nineteen dually diagnosed veterans who entered VR in the Veterans' Administration's compensated work therapy (CWT) program were randomly assigned to CWT (n = 8) or to CWT with enhanced incentives (n = 11). Over the first 16 weeks of rehabilitation, those in the incentives condition could earn up to dollar 1,006 in cash for meeting two sets of clinical goals: (a) remaining abstinent from drugs and alcohol and (b) taking steps to obtain and maintain a competitive job. Results indicate that relative to participants in the CWT-only group, those in the incentives condition engaged in more job-search activities, were more likely to remain abstinent from drugs and alcohol, were more likely to obtain competitive employment, and earned an average of 68% more in wages. These results suggest that rehabilitation outcomes may be enhanced by restructuring traditional work-for-pay contingencies to include direct financial rewards for meeting clinical goals.

Diagnosis, Dual (Psychiatry)↗
PubMed1999

Retail trade incentives: how tobacco industry practices compare with those of other industries.

OBJECTIVES: This study compared the incentive payments for premium shelf space and discounts on volume purchases paid to retailers by 5 types of companies. METHODS: Merchants were interviewed at 108 randomly selected small retail outlets that sell tobacco in Santa Clara County, California. RESULTS: Significantly more retailers reported receiving slotting/display allowances for tobacco (62.4%) than for any other product type. An average store participating in a retailer incentive program received approximately $3157 annually from all sampled product types, of which approximately $2462 (78%) came from tobacco companies. CONCLUSIONS: Future research should assess the impact of tobacco industry incentive programs on the in-store marketing and sales practices of retailers.

Advertising↗
PubMed2001

The relation between community bans of self-service tobacco displays and store environment and between tobacco accessibility and merchant incentives.

OBJECTIVES: These studies investigated (1) the effect of community bans of self-service tobacco displays on store environment and (2) the effect of consumer tobacco accessibility on merchants. METHODS: We counted cigarette displays (self-service, clerk-assisted, clear acrylic case) in 586 California stores. Merchant interviews (N = 198) identified consumer tobacco accessibility, tobacco company incentives, and shoplifting. RESULTS: Stores in communities with self-service tobacco display bans had fewer self-service displays and more acrylic displays but an equal total number of displays. The merchants who limited consumer tobacco accessibility received fewer incentives and reported lower shoplifting losses. In contrast, consumer access to tobacco was unrelated to the amount of monetary incentives. CONCLUSIONS: Community bans decreased self-service tobacco displays; however, exposure to tobacco advertising in acrylic displays remained high. Reducing consumer tobacco accessibility may reduce shoplifting.

Advertising↗
PubMed1976

Effects of incentive and preparatory interval on activity, heart rate, and reaction time in children.

To resolve certain empirical and theoretical difficulties concerning, primarily, the significance of phasic heart-rate deceleration prior to reaction signals, 48 children were employed to perform in simple reaction-time tasks while speed, heart rate, head movement, gross movement, and blink activity were recorded. The indeory intervals and level of incentives. Reaction time varied with incentive, with preparatory interval and mode of presentation. Phasic heart-rate deceleration varied with the intervals but not incentive or mode of presentation. There was little relation between deceleration and RT. Heart rate and somatic movement measures (especially of blinking) were roughly concordant at a group level but did not correlate.

Acoustic Stimulation↗
PubMed1994

Analysis of course type, gender, and personal incentives to exercise.

206 women and 88 men enrolled in classes requiring different amounts of physical activity were administered the Personal Incentives for Exercise Questionnaire. A two-way multivariate analysis of variance, with course type and gender as the categorical independent variables and 10 subscale scores representing incentives to exercise as the multivariate dependent variables, was completed. Canonical discriminant analysis was used to identify which of the incentives is most useful in discriminating among participants in active and less active classes or between men and women. For main effects, analysis indicated an over-all significant difference for both course type and gender. Men scored higher than women on activity and on competition, for example, while women scored higher on appearance and weight management.

Adolescent↗
PubMed1994

Using incentives to promote workers' participation in worksite research.

We designed this study to examine the effects of two types of incentives on the participation rate of workers from two plants in worksite research. There were 186 workers in the study, some of whom received chances for savings bonds. Given reductions in funding and concerns of management, no comparison could be made between the incentives; however, the study provided valuable information regarding planning for incentives in worksite research.

Adult↗
PubMed1999

Effects of a small monetary incentive and follow-up mailings on return rates of a survey to nurse practitioners.

The purpose was to examine the effectiveness of a modest monetary incentive ($1) and none in increasing the response rate of a mail survey to 600 nurse practitioners. The response rate in the incentive group was 81% and 66% in the control group, significant by chi-square test. The most cost effective survey technique for increasing the response rate of nurse practitioners was to code the envelopes and eliminate the monetary incentive.

Adult↗
PubMedDate not supplied

Academic incentives for students can increase participation in and effectiveness of a physical activity program.

The authors sought to determine whether a greater academic incentive would improve the effectiveness and student adherence to a 12-week voluntary exercise program designed to decrease students' percentage of body fat. They randomly assigned 210 students to 1 of 2 groups with different academic reward structures. The group with the greater reward structure showed better exercise adherence and lost more body fat than those without the additional incentive. These findings suggest that an academic incentive can increase overall student adherence to a voluntary exercise program and can boost the effectiveness of the program in a university environment. The findings also have potential implications for on-campus promotion of physical activity.

Exercise↗
PubMed1991

Is the hospital patient market receptive to incentives? Results of an attitude survey.

A survey was taken of attitudes towards offering five specific services, free of charge, as incentives to encourage patients to choose a hospital different from their current preference. 48.5% of those interviewed indicated incentives would influence their choice. Twenty-three percent would use incentives even when their physician recommends another hospital.

Age Factors↗
PubMed2000

Intra-accumbens amphetamine increases the conditioned incentive salience of sucrose reward: enhancement of reward "wanting" without enhanced "liking" or response reinforcement.

Amphetamine microinjection into the nucleus accumbens shell enhanced the ability of a Pavlovian reward cue to trigger increased instrumental performance for sucrose reward in a pure conditioned incentive paradigm. Rats were first trained to press one of two levers to obtain sucrose pellets. They were separately conditioned to associate a Pavlovian cue (30 sec light) with free sucrose pellets. On test days, the rats received bilateral microinjection of intra-accumbens vehicle or amphetamine (0.0, 2.0, 10.0, or 20.0 microgram/0.5 microliter), and lever pressing was tested in the absence of any reinforcement contingency, while the Pavlovian cue alone was freely presented at intervals throughout the session. Amphetamine microinjection selectively potentiated the cue-elicited increase in sucrose-associated lever pressing, although instrumental responding was not reinforced by either sucrose or the cue during the test. Intra-accumbens amphetamine can therefore potentiate cue-triggered incentive motivation for reward in the absence of primary or secondary reinforcement. Using the taste reactivity measure of hedonic impact, it was shown that intra-accumbens amphetamine failed to increase positive hedonic reaction patterns elicited by sucrose (i.e., sucrose "liking") at doses that effectively increase sucrose "wanting." We conclude that nucleus accumbens dopamine specifically mediates the ability of reward cues to trigger "wanting" (incentive salience) for their associated rewards, independent of both hedonic impact and response reinforcement.

Amphetamine↗
PubMed2001

["Replacement Methods to Animal Testing" as the incentive topic of the German Ministry of Education and Research. Selected results on biological drugs].

Since 1980, BMBF, in co-operation with the appointed project representative BEO (Biology, Energy, Environment), supports research projects with the central goal of the reduction of animal testing. Beginning with the announcement about promoting "Projects in Replacement Methods to Animal Testing" in 1984, a separate incentive topic of research was fostered within the framework of the biotechnological program of the German Federal Government. It is being updated continuously by current reports. The BMBF incentive topic represents the largest and longest running support activity in the field world-wide. During a time-span of 20 years, about 14 million German Marks (approx. 7 millions per annum) were provided, supporting about 230 projects. To date, all applications judged favourably in regard to contributing to potential and substantial savings could also be funded. The incentive topic is being realised in accordance with the 3R principle, following Russel and Burch. Primary attention is given to tests with high levels of stress or involving large numbers of animals. At present, special attention is given to the development and validation of alternatives to animal testing which are required by law. Emphasis is also put on joint projects by testing and regulation authorities together with industrial users in order to broaden the application of these methods and to aid in accelerating the amendment of respective legal regulations. The BMBF continues to adhere to the objectives of the emphasised support and will furnish funding at the present level in the future. Also, together with representatives of testing- and regulating authorities, of industry, science, respective federal authorities and animal protection, the BMBF has developed a new concept to expand funded activities in the future to include animal testing in basic research in a target-fashioned structure. This will be published shortly through a new public announcement. As a complement to the present application procedure ("bottom-up-principle"), new research approaches are being prepared within a limited scope regarding particularly relevant topics (i.e. transgenic animal models) as a "top-down-principle" by means of workshops and accompanying studies. Additionally, reports are appearing concerning the results of selected projects supported by the emphasised support of the BMBF for "Biologica", particularly regarding the realisation of results in the practical reduction of animal testing. The BMBF is supporting a total of 27 projects with respect to "Biologica". Central to the majority of these projects (21) is the test of vaccines, and there in particular, the potency test of particular vaccines. Using four examples, it is being demonstrated that the practical translation of the results of projects always requires the co-operation of the respective partners, and that the complete application of suitable replacement methods usually becomes possible only after the conclusion of a phase of development and testing of several years.

Animal Testing Alternatives↗
PubMed2001

Incentive sensitization by previous amphetamine exposure: increased cue-triggered "wanting" for sucrose reward.

We reported previously that an amphetamine microinjection into the nucleus accumbens enables Pavlovian reward cues in a conditioned incentive paradigm to trigger excessive instrumental pursuit. Here we show that sensitization caused by previous amphetamine administration also causes reward cues to trigger excessive pursuit of their associated reward, even when sensitized rats are tested in a drug-free state. Rats learned to lever press for sucrose pellets, and they separately learned to associate sucrose pellets with Pavlovian cues (30 sec auditory cues). Amphetamine sensitization was induced by six daily injections of amphetamine (3 mg/kg, i.p.; controls received saline). Rats were tested for lever pressing under extinction conditions 10 d later, after a bilateral microinjection of intra-accumbens vehicle or amphetamine (5 microg/0.5 microl per side). Cue-triggered pursuit of sucrose reward was assessed by increases in pressing on the sucrose-associated lever during intermittent presentations of a free conditioned stimulus (CS+) sucrose cue. Sensitized rats pressed at normal levels during baseline and during the CS-, but the CS+ triggered 100% greater increases in pressing from sensitized rats than from control rats after vehicle microinjection. Sensitization therefore enhanced the incentive salience attributed to the CS+ even when rats were tested while drug-free. For control rats, a microinjection of intra-accumbens amphetamine was needed to produce the same enhancement of cue-triggered reward "wanting." The amphetamine microinjection also interacted synergistically in sensitized rats to produce intrusive cue-triggered pursuit behaviors (e.g., investigatory sniffing) that interfered with goal-directed lever pressing. These results support the incentive-sensitization theory postulate that sensitization causes excessive cue-triggered "wanting" for an associated reward.

Acoustic Stimulation↗
PubMed2004

Using provider and member incentives to boost quality.

Studies show physicians have mixed feelings about incentives aimed at boosting their performance. But when properly designed, incentives can not only improve quality, but nurture relationships with the provider network as well. A new report offers guidance on how to fashion an incentive program that will get results.

Disease Management↗