An inquiry into patient and general practice attitudes to financial quality-care incentives in primary care: Pre-intervention data from the EQuIP-GP trial

Context: There are major challenges in delivering economically sustainable healthcare in Australia. The RACGP funded EQuIP-GP trial is investigating a general practice funding model that provides targeted, continuous quality incentive payments for activities related to higher quality care such as increased continuity of care of a patient by the one general practitioner (GP).

Objective: To report preliminary baseline analyses of interviews with patients, GPs and practice managers investigating attitudes to, and beliefs about, quality improvement incentive payments to GPs.

Design: Nested qualitative case studies within a cluster randomised controlled trial.

Setting: Thirty-three general practices in three Australian states recruited to the EQuIP-GP trial.

Participants: Two practices were purposively selected in each of the three states. Eighteen interviews were analysed across the practices using a framework approach.

Findings: Across the varied geographic and socioeconomic contexts of the practices, patients and practice staff alike believed the care provided was of good quality. Among participants in these preliminary analyses, quality was synonymous with patient-centred care. Whilst GPs and practice staff believed quality care cost more to deliver, most patients were ambivalent about this link.

Implications for practice: The results of this study may assist understanding perceptions of the link between quality of care delivered by Australian general practice and financial considerations. The financial implications of providing high-quality care are poorly appreciated by patients. Shared understandings between GPs and patients may enhance acceptability of financial incentives for high quality general practice care.