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.

SourceResearch connectionFrom yearThrough year

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

At least 559 records · Page 31Linked to original sources

PubMed2005

Do incentives matter? Providing benefits to families of organ donors.

Whether the number of organs available for transplant would be positively or negatively affected by providing benefits to families of organ donors has been debated by policymakers, ethicists and the transplant community at large. We designed a telephone survey to measure public opinion regarding the use of benefits in general and of five types in particular: funeral benefits, charitable contributions, travel/lodging expenses, direct payments and medical expenses. Of the 971 adults who completed the survey (response rate = 69%), all were from Pennsylvania households, 45.6% were registered organ donors, and 51.7% were nonwhite. Although 59% of respondents favored the general idea of incentives, support for specific incentives ranged from 53% (direct payment) to 84% (medical expenses). Among those registered as donors, more nonwhites than whites supported funeral benefits (88% vs. 81%; p = 0.038), direct payment (63% vs. 41%; p < 0.001) and medical expenses (92% vs. 84%; p = 0.013). Among those not registered as donors, more nonwhites supported direct payment (64% vs. 46%; p = 0.001). Most respondents believed that benefits would not influence their own behavior concerning donation but would influence the behavior of others. While benefits appear to be favored, their true impact can only be assessed through pilot programs.

Adolescent↗

PubMed1992

The Midfield High School Safety Belt Incentive Program.

Motor vehicle accidents constitute the leading cause of death among children and youth ages 15-24. The Year 2000 Health Objectives for the Nation call for reduction in fatalities in this population through increasing occupant restraint measures. This article provides an overview of how one school district developed a school and community safety belt incentive program to increase safety belt use among high school students. The intervention program followed a seven-step process, involving community leaders, school officials, students, and local law enforcement personnel in its design, implementation, and evaluation. Local merchants and the Alabama Dept. of Health donated program incentives. Measurement of safety belt use among the target population revealed increased use throughout the program.

Adolescent↗

PubMed1970

Integrated incentives for fertility control.

Incentive proposals for fertility control have stimulated considerable debate and only narrowly conceived trials. As a result, there exists a tendency to dismiss almost offhandedly the entire concept of using material incentives to further contraceptive practice before any have been adequately tried. Moreover, a majority of proposals thus far have been characterized by a search to uncover the "one best way" to circumvent the myriad frustrations encountered in attempting to reduce birthrates in traditional societies.

Community Health Services↗

PubMed2006

[What incentives foster hospital use in the National Health Service?].

BACKGROUND: Geographic variations in medical practice have been widely described and different underlying causes have been proposed. Basically, when evidence about effectiveness is strong variations are lower and, probably, it reflects patient needs differences; nevertheless, when either uncertainty or ignorance about effectiveness dominates, medical decision making is particularly sensitive to supply. In this paper we argue about the factors (incentives) influencing hospital utilization in the Spanish National Health Service (sNHS). MATERIAL AND METHOD: We have compared both sNHS utilization rates and those in MEDICARE (US Federal Health System for elderly and handicapped population). RESULTS: 1) Utilization rates in Spain were lower than in MEDICARE for most of the conditions and procedures under study. However, knee or hip replacement and cholecystectomy rates were similar; 2)unlike what happened in MEDICARE, supply, as total beds per 1,000 inhabitants, showed either negative or no correlation with utilization rates; however, those populations which get more interventions get more of whatever the surgery performed; 3)High tech hospitals, in terms of tertiary and teaching hospitals, perform less < > interventions; on the other hand, < > utilization rates were closed to those in MEDICARE. CONCLUSIONS: Differences between both Health Care Systems suggest a different structure of incentives working under variations. Here in Spain, instead of supply, < > is becoming the alternative explanation. If true, < > hypothesis entails a model of National Health Service focused on technology instead of patient needs.

Aged↗

PubMed2005

The effect of family size on incentive effects of welfare transfers in two-parent families: an evaluation using experimental data.

Family size is an important determinant of family well-being, and it is a good predictor of poverty. This study examines effects of waiving the 100-hour rule, by family size, and distinguishes between the "work-incentive effects" and the "eligibility effects" of the waiver. The 100-hour rule limits eligibility to aid to two-parent families in which the principal earner is unemployed or underemployed (works fewer than 100 hours per month). The study uses data from the Link-Up randomized experiment, conducted in California's Central Valley, from 1992 to 1994. The findings show that the eligibility effect of the waiver does not differ by family size, but the work-incentive effect does.

California↗

PubMed2003

Strategies for integrating Medicare and Medicaid: design features and incentives.

In a typical third-party payer situation--representative of most U.S. health care delivery--the payer is likely to have interests that are at odds with the patient and provider. The separation and overlap between Medicare and Medicaid for individuals eligible for both programs introduces an additional level of complexity: multiple masters over plans, providers, and patients. This creates opportunities for shifting costs and administrative burdens between states and the federal government, providers and governments, and patients and everyone else. Program designers who wish to minimize unwanted consequences must find ways to structure their programs to produce financial incentives that encourage the pursuit of societal goals, including appropriately shared intergovernmental responsibilities and appropriate plan, provider, and patient behavior. Here the authors review nine federal and state initiatives that use varying strategies to integrate Medicare and Medicaid services for vulnerable populations. For each initiative, the authors examine and critique program design features in three areas: (1) eligibility determination, (2) finance and administration, and (3) service delivery. They find a few strengths and many weaknesses in design. Future efforts would be well served by carefully considering the incentive structures designed into these initiatives and working to improve them in the next generation of Medicare-Medicaid integration efforts.

Acute Disease↗

PubMed1987

Effectiveness and cost effectiveness of persuasive communications and incentives in increasing safety belt use.

The Safety Belt Connection Project was a worksite health promotion project conducted at a medical school and hospital complex to test the effectiveness and cost effectiveness of four treatment conditions (TCs): TC1, Persuasive Communications (PCs) alone; TC2, PCs plus overt monitoring; TC3, PCs plus incentives; and TC4, PCs plus incentives and prompts. Parking lots were randomized to treatment condition. A community traffic intersection served as a comparison group. Trained observers recorded safety belt use rates (SBURs) of subjects (front seat occupants) over a two-week period at baseline and after a four-week period of intervention. Results were analyzed by chi-square comparisons of pre-treatment and post-treatment SBURs. At baseline, significant differences in SBURs between treatment groups were observed. Significant pre-to-post differences were found for TC3 and TC4: the SBUR in TC3 went from 18.3% - 38.4% (p less than 0.001) and the SBUR in TC4 went from 16.9% - 44.8% (p less than 0.001). Both TC3 and TC4 were effective, but TC4 cost 2.6 times more per person influenced to wear their safety belt.

Communication↗

PubMed2006

Scratch lottery tickets are a poor incentive to respond to mailed questionnaires.

BACKGROUND: It has been demonstrated that the enclosure of money with a mailed questionnaire increases the response rate significantly. We evaluated scratch lottery tickets as an alternative to cash. METHODS: 1500 randomly selected Norwegians between the ages of 40 and 65 years were sent a short questionnaire. 250 received one lottery scratch ticket worth 20 Norwegian kroner (approximately 3 USD) together with the questionnaire, 250 received two scratch tickets, and 250 were promised two scratch tickets if they replied within one week. A fourth group of 250 persons received a 50 kroner banknote with the questionnaire. The remaining 500 letters served as controls. RESULTS: The overall response rate after 6 weeks was 77%. Logistic regression analysis showed that only the 50 kroner group had a response rate that was statistically significantly higher than the controls (p < 0.0001). It was also significantly higher than that in any of the other incentive groups (p < 0.0001, p < 0.004 and p < 0.0001 respectively). Female sex (p < 0.001) and age (p < 0.002) increased the response rate significantly. CONCLUSION: It is possible that the recipients scratched their cards before completing the questionnaire, and that it was a disincentive for the majority that they did not win anything. Lottery scratch tickets are no substitute for cash as an incentive to respond to a questionnaire.

Adult↗

PubMed2006

Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe.

BACKGROUND: Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIV-positive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment, emotional underdevelopment, illiteracy, poverty, sexual exploitation, and HIV infection, endangering the future health of the society they are expected to sustain. METHODS: To explore barriers and possible incentives to orphan care, a quantitative cross-sectional survey in rural eastern Zimbabwe asked 371 adults caring for children, including 212 caring for double orphans, about their well-being, needs, resources, and perceptions and experiences of orphan care. RESULTS: Survey responses indicate that: 1) foster caregivers are disproportionately female, older, poor, and without a spouse; 2) 98% of non-foster caregivers are willing to foster orphans, many from outside their kinship network; 3) poverty is the primary barrier to fostering; 4) financial, physical, and emotional stress levels are high among current and potential fosterers; 5) financial need may be greatest in single-orphan AIDS-impoverished households; and 6) struggling families lack external support. CONCLUSION: Incentives for sustainable orphan care should focus on financial assistance, starting with free schooling, and development of community mechanisms to identify and support children in need, to evaluate and strengthen families' capacity to provide orphan care, and to initiate and support placement outside the family when necessary.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Commodifying life? A pilot study of opinions regarding financial incentives for organ donation.

In recent years many policy proposals have been put forward to create financial incentives to encourage families to allow the harvesting of organs from their deceased relatives. While research has focused on whether these policies would actually increase the supply of organs, no research has focused on testing the ethical concerns about such policies. This article presents the findings of a pilot study conducted to determine whether people think that families should end life support of a family member in order to harvest organs if various incentive policies are in place. While the findings do not suggest a direct effect of these inducements, they do indicate that the amount of money received from organ donation is a consideration in making the decision whether to end life support. The implications of this finding for ethical debates and health policy are reviewed.

Cadaver↗

PubMed2004

Financial incentives for cadaveric organ donation.

One of the main obstacles of organ transplantation all over the world is the insufficient number of available cadaveric organs. Various attempts are considered to increase the consent rate. Financial incentives as a possibility to raise the number of procured organs is a very controversial topic. Arguments for and against financial incentives are presented as well as the different models.

Cadaver↗

PubMed1996

College student's blood donation behavior: relationships to demographics, perceived risk, and incentives.

A study was undertaken to empirically investigate whether the student market could be further segmented into blood donor and nondonor markets based on their demographic characteristics, perceived risks, and influence on non-monetary incentives. While significant differences were found between donors and nondonors based on their gender, blood type, student classification, and influence of incentives, no differences were found between the four (physical, psychological, social, or time) dimensions of perceived risk. Discussion focuses on strategies for blood collection agencies for student markets.

Adolescent↗

PubMedDate not supplied

Costs and incentives in a behavioral health carve-out.

A carve-out of mental health and substance abuse services initiated in 1993 by the Group Insurance Commission (GIC) of the Commonwealth of Massachusetts resulted in changes in the costs of those services. Those changes were related to incentives in the contract between the GIC and its managed behavioral health vendor. Total and plan costs were reduced by 30-40 percent after adjusting for trends. Incentives to produce savings of this magnitude not only were a consequence of the payer/vendor contract but, we speculate, derive from the growth potential facing companies in the managed behavioral health care market.

Contract Services↗

PubMedDate not supplied

How do incentive-based formularies influence drug selection and spending for hypertension?

This study examined the association between incentive-based formularies and antihypertensive drug selection and spending. We compared the use of drugs from five drug classes by the number of tiers and copayment differentials. We found that raising copayments within a single-tier formulary system had a relatively modest impact on use of antihypertensives, compared with raising them in multi-tier systems. Likelihood of using ACE inhibitors and angiotensin II receptor blockers was lower among two-tier plans with generic/brand differentials of dollars 10 relative to flat-copayment plans. Incentive formularies were associated with lower total antihypertensive spending by plans, but enrollees paid more out of pocket.

Deductibles and Coinsurance↗

PubMed2001

The effect of incentive spirometry on postoperative pulmonary complications: a systematic review.

OBJECTIVE: To systematically review the evidence examining the use of incentive spirometry (IS) for the prevention of postoperative pulmonary complications (PPCs). METHODS: We searched MEDLINE, CINAHL, HealthSTAR, and Current Contents databases from their inception until June 2000. Key terms included "incentive spirometry," "breathing exercises," "chest physical therapy," and "pulmonary complications." Articles were limited to human studies in English. A secondary search of the reference lists of all identified articles also was conducted. A critical appraisal form was developed to extract and assess information. Each study was reviewed independently by one of three pairs of group members. The pair then met to reach consensus before presenting the report to the entire review group for final agreement. RESULTS: The search yielded 85 articles. Studies dealing with the use of IS for preventing PPCs (n = 46) were accepted for systematic review. In 35 of these studies, we were unable to accept the stated conclusions due to flaws in methodology. Critical appraisal of the 11 remaining studies indicated 10 studies in which there was no positive short-term effect or treatment effect of IS following cardiac or abdominal surgery. The only supportive study reported that IS, deep breathing, and intermittent positive-pressure breathing were equally more effective than no treatment in preventing PPCs following abdominal surgery. CONCLUSIONS: Presently, the evidence does not support the use of IS for decreasing the incidence of PPCs following cardiac or upper abdominal surgery.

Abdomen↗

PubMed1985

Prevention of postoperative pulmonary complications with CPAP, incentive spirometry, and conservative therapy.

Continuous positive airway pressure (CPAP) administered at intervals with a mask and incentive spirometry (IS) were compared with a regimen of coughing and deep breathing (CDB) to determine which promoted the most rapid recovery of pulmonary function after upper abdominal operations in 65 adults. Postoperatively, FRC of patients in all groups was similar relative to preoperative values. However, mean FRC of patients who received CPAP increased more rapidly than did mean FRC of those receiving CDB when compared to the values obtained following operation (p less than 0.05). Incentive spirometry did not increase FRC to a greater extent than did CDB. Roentgenographic evidence of atelectasis 72 hours postoperatively was observed in 23 percent of CPAP patients (five of 22) and 42 percent and 41 percent of patients who received CDB (eight of 19) and IS (nine of 22). Two patients (3 percent) developed pneumonia. The low incidence of pneumonia regardless of the type of therapy may be attributable to vigorous, vigilant respiratory care in a population at high risk for developing pneumonia. Frequency and supervision of respiratory therapy may be more important than the type of therapy delivered after upper abdominal operations. Mask CPAP offers advantages because it requires no effort from the patient, and therapy is not painful.

Abdomen↗

PubMed2005

Subthalamic nucleus lesions enhance the psychomotor-activating, incentive motivational, and neurobiological effects of cocaine.

The subthalamic nucleus (STN) is traditionally thought to be involved in motor control, and dysfunction of the STN is thought to contribute to movement disorders. Here, we show that the STN also plays an important role in motivational processes and the response to drugs of abuse. Specifically, bilateral STN lesions produced a dose-dependent increase in the psychomotor-activating effects of cocaine, the rate at which animals acquired cocaine self-administration, and the motivation for cocaine assessed using a progressive ratio schedule. Furthermore, bilateral STN lesions enhanced the ability of cocaine to induce gene expression in the nucleus accumbens and caudate-putamen, two structures known to be involved in mediating the psychomotor-activating and incentive motivational effects of drugs of abuse. These findings suggest that engagement of the STN serves to dampen the psychomotor-activating and incentive motivational effects of drugs of abuse. Thus, the STN may serve as a novel target for therapeutic interventions aimed at treating drug dependence.

Animals↗

PubMed1991

Enforcement or incentives? Promoting safety belt use among military personnel in the Netherlands.

During a nationwide campaign to promote safety belt use among military personnel, a field study was conducted at 12 different military bases in the Netherlands. Amount of enforcement, type of publicity, and incentive strategies were varied among military bases. Observations of safety belt use among servicemen in their personal vehicles were conducted before the campaign, immediately following the campaign, and 3 months later. Safety belt use increased from 65% during baseline to 73% directly after the campaign and to 76% 3 months later. An overall 28.6% increase in safety belt use (from 63% to 81%) was observed at seven bases, whereas no changes were found at five bases (68% on all occasions). To a large degree the effects were due to a 37.7% increase among young drivers. These results confirmed that enforcement, as well as incentives, can be effective in promoting safety belt use. However, treatment effects were not systematic, thereby complicating the interpretation of the results. Implications of these varied outcomes are discussed.

Journal Article↗