The Association of Patient Satisfaction-Based Incentives with Primary Care Physician Opioid Prescribing

J Am Board Fam Med. 2018 Nov-Dec;31(6):941-943. doi: 10.3122/jabfm.2018.06.180067.

Abstract

Purpose: The opioid epidemic in the United States is an ongoing public health concern. Health care institutions use standardized patient satisfaction surveys to assess the patient experience and some offer incentives to their providers based on the results. We hypothesized that providers who report being incentivized based on patient satisfaction surveys are more likely to report an impact of such surveys on their opioid prescribing practices.

Methods: We developed a 23-item survey instrument to assess the self-perceived impact of patient satisfaction surveys on opioid prescribing practices in primary care and the potential impact of institutional incentives. The survey was emailed to all 1404 members of the Colorado Academy of Family Physicians.

Results: The response rate to the online survey was 10.4% (n = 146). Clinical indications for which responders prescribe opioids included acute pain (93%), cancer pain (85%), and chronic nonmalignant pain (72%). Among physicians using patient satisfaction surveys, incentivized physicians reported at least a slight impact on opioid prescribing 3 times more often than physicians who were not incentivized (36% vs 12%, P = .004).

Conclusions: Efforts to improve patient satisfaction may have potentially untoward effects on providers' opioid prescribing behaviors. Our results suggest a need to further study the impact of provider incentive plans that are based on patient satisfaction scores.

Keywords: Acute Pain; Chronic Pain; Colorado; Family Physicians; Incentives; Opioid Analgesics; Patient Satisfaction; Primary Health Care; Public Health; Surveys and Questionnaires.

Publication types

  • Letter
  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Attitude of Health Personnel
  • Colorado
  • Drug Prescriptions / statistics & numerical data*
  • Electronic Mail / statistics & numerical data
  • Epidemics / prevention & control
  • Humans
  • Motivation
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / prevention & control
  • Patient Satisfaction*
  • Physician Incentive Plans*
  • Physicians, Family / psychology
  • Physicians, Family / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Primary Health Care / economics
  • Primary Health Care / organization & administration
  • Primary Health Care / statistics & numerical data*
  • Surveys and Questionnaires / statistics & numerical data

Substances

  • Analgesics, Opioid