Evidence map›Paper›PMID 39671407›Full record

Trial reportFamily practice2025

'It's what we should be doing anyway': using financial incentives to promote relational continuity in Australian General Practice-a nested case study analysis.

Grant Russell, Susannah Westbury, Jenny Advocat, Nicholas Zwar, Christine Metusela, Marijka Batterham, Gregory M Peterson, Judy Mullan, Danielle Mazza, Jan Radford and 2 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Family practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. What do patients and clinicians think about continuity in general practice in England? a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  2. Primary care stability as a social determinant.Frontiers in health services · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Grant RussellDepartment of General Practice, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia.
Susannah WestburyDepartment of General Practice, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia.ORCID 0000-0002-5866-7778
Jenny AdvocatSchool of Primary and Allied Health Care, Building G, Level 3, Monash University, Peninsula Campus,  Frankston, Victoria 3199, Melbourne, Australia.
Nicholas ZwarFaculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD 4226, Gold Coast, Australia.
Christine MetuselaSchool of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
Marijka BatterhamSchool of Mathematics and Applied Statistics, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
Gregory M PetersonSchool of Pharmacy and Pharmacology, University of Tasmania, Churchill Avenue, Sandy Bay, TAS 7005, Australia.
Judy MullanSchool of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
Danielle MazzaDepartment of General Practice, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004, Australia.ORCID 0000-0001-6158-7376
Jan RadfordSchool of Medicine, University of Tasmania, Level 3, 43 Collins Street, Hobart, TAS 7000, Australia.
Simon EckermannSchool of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
Andrew BonneySchool of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.ORCID 0000-0003-2477-1646

Funding

Australian Government Department of HealthRoyal Australian College of General Practitioners
6 · The paper itself

Abstract

backgroundRelational continuity is a fundamental component of primary care. The 'Quality in General Practice Trial' (EQuIP-GP), was a 12-month cluster randomized trial, designed to investigate whether financial incentives can improve relational continuity in primary care.

aimTo examine (i) how financial incentives are perceived and experienced by primary care patients, providers, and practice staff, and (ii) how clinical and organizational routines related to relational continuity are influenced by the introduction of a financial model designed to incentivize relational continuity. DESIGN AND

settingWe used a mixed methods case study approach with six of the intervention arm practices participating in the EQuIP-GP trial.

methodSemi-structured interviews were conducted with patients, providers, practice staff, and intervention facilitators. Intervention facilitators kept structured diaries to capture reflective notes. To contextualize results, practices completed a modified practice attributes survey and patients completed the Primary Care Assessment Tool at baseline and 12 months.

resultsPatient-perceived relational continuity was not impacted by the intervention. Financial incentives were preferred for rewarding, as opposed to incentivizing, quality care; however, they were perceived as a blunt and inflexible instrument. The introduction of the incentive model increased attention to pre-existing organizational routines rather than creating new ones.

conclusionIncentive models should be suitably flexible to accommodate diversity in patient and practice needs. Small changes can be made to existing practice routines that will improve awareness and conscientiousness of relational continuity. Further research should examine how feasible these routine changes would be in practices that do not already focus on continuity.

Indexed as

Continuity of Patient CareGeneral PracticeMotivationPhysician-Patient RelationsAdultAgedAustraliaFemaleHumansInterviews as TopicMaleMiddle AgedPrimary Health CareQualitative Researchcontinuity of carefinancial incentivesgeneral practicepay for performancePrimary health carerelational continuity

Identifiers

PMID39671407
PMCPMC11770818

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.