Financial Incentive Systems Research Articles

Financial incentives for a healthy life style and disease prevention among older people: a systematic literature review.

BackgroundTo motivate people to lead a healthier life and to engage in disease prevention, explicit financial incentives, such as monetary rewards for attaining health-related targets (e.g. smoking cessation, weight loss or increased physical activity) or disincentives for reverting to unhealthy habits, are applied. A review focused on financial incentives for health promotion among older people is lacking. Attention to this group is necessary because older people may respond differently to financial incentives, e.g. because of differences in opportunity costs and health perceptions. To outline how explicit financial incentives for healthy lifestyle and disease prevention work among older persons, this study reviews the recent evidence on this topic.MethodsWe applied the method of systematic literature review and we searched in PUBMED, ECONLIT and COCHRANE LIBRARY for studies focused on explicit financial incentives targeted at older adults to promote health and stimulate primary prevention as well as screening. The publications selected as relevant were analyzed based on directed (relational) content analysis. The results are presented in a narrative manner complemented with an appendix table that describes the study details. We assessed the design of the studies reported in the publications in a qualitative manner. We also checked the quality of our review using the PRISMA 2009 checklist.ResultsWe identified 15 studies on the role of explicit financial incentives in changing health-related behavior of older people. They include both, quantitative studies on the effectiveness of financial rewards as well as qualitative studies on the acceptability of financial incentives. The quantitative studies are characterized by a great diversity of designs and provide mixed results on the effects of explicit financial incentives. The results of the qualitative studies indicate limited trust of older people in the use of explicit financial incentives for health promotion and prevention.ConclusionsMore research is needed on the effects of explicit financial incentives for prevention and promotion among older people before their broader use can be recommended. Overall, the design of the financial incentive system may be a crucial element in their acceptability.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1517-0) contains supplementary material, which is available to authorized users.

Motivational effects of pay dispersion in pay for performance programs implemented in Romanian companies

Abstract The present study investigates the motivational effects in a sample of Romanian employees in private companies that implement pay for performance programs of one of the characteristics of these programs, namely pay dispersion, and on the potential mediating role of organizational justice in these effects. To this aim, we examined the relationships between the amounts of pay dispersion introduced by the respective financial incentive system, employee perceptions of distributive and procedural justice, work motivation, and base salary, respectively. The results of the data analysis, performed through structural equation modeling, support our hypotheses concerning the positive effect of performance – related pay dispersion on motivation and the mediating role of the two dimensions of organizational justice in this effect. Larger financial rewards allocated by the financial incentive system for high performers increase employee perceptions of distributive and procedural justice, which, in turn, foster work motivation. Base salary was also found to influence pay dispersion, as well as perceived distributive justice.

Financial incentives: Possible options for sustainable rangeland management?

Large-scale mismanagement of natural resources emanating from lack of appropriate policies and regulatory framework is arguably one of the reasons that led to resource degradation and poor livelihoods in many countries in the Middle East and North Africa (MENA) region. Sustainable rangeland management practices (SRMPs) are considered to be a solution to feed shortages and rangeland degradation. However, the scope for SRMP adoption, has been a subject of debate. Using a case study from Syria and the application of the Minimum Data Analysis method (TOA-MD), this paper provides empirical evidence for ensuring wider adoption of SRMP. The paper argues that the introduction of financial incentives in the form of payments for agricultural-environmental services can increase the economic viability and enhance the adoption of SRMPs and is a better alternative to the unsustainable state subsidies for fodder purchases and barley cultivation on rangelands. Model results indicate that further investment in reasearch toward generating low cost technologies and tailored governance strategies including a financial incentive system would lead to better management of rangelands and improve livelihoods in the Syrian Badia. These findings are valuable for policy makers, donors as well as development and extension practitioners in the MENA region as they can better inform future courses of actions.

Мотивация инновационной деятельности персонала в системе управления постоянным развитием предприятия.

In the article were identified: the main categories of motivational process, features of the formation of the mechanism of of staff innovative activity. Analysis of modern scientific views of the concept motivation of staff showed that the of innovation is a set of needs and motives that encourage staff and management to the creative activity in order to create innovative products, services, forms of their implication, implementation of new technologies in order to ensure improvement of the quality and competitiveness of the labor work. High level of education and intellectual activity is important for the implementation of innovation activity: the more creative and intellectual challenges in the function, the more noticeable the role of non-material incentives in the process of innovation activity. Lack of the developed system of financial incentives and certain guarantees of social protection, absence of improved means of evaluation of the results of work and incentives to creative and active work are considered to be the main determining factors of the reduction of the creative activity of Ukrainian workers. Each stage of the innovation process is influenced by different motivational factors that facilitate or hinder the implementation of the idea. Based on the results of the survey which was held among employees of enterprises of transport sector the main motivating factors that promote innovation are: opportunities for the professional and personal growth, understanding of the directions of the development, faith in its future. In the article were proposed directions how to improve the application of motivational factors in innovation management activity, appliance of which will increase staff productivity and level of the innovativeness of the enterprise.

Russian experience and perspectives of quality assurance in healthcare through standards of care

ObjectivesThe main reform of healthcare system in Russia had begun by introduction of compulsory healthcare insurance in 1993. Since this time, Russia went through number of steps of healthcare system modernization. Most attention was paid to the resource allocation, medical equipment and drug provision, the problem of the low quality of care was repeatedly addressed. Major direction of the efforts was the creation of obligatory technical standards of care. MethodsI studied the volume of publication found in MEDLINE for period 1991–2014 and in the relevant Russian journals not covered by MEDLINE as well as legislation on health care introduced since 1991. ResultsThe review found that despite some increase in volume of funding of health care system, and provision of incentives for quality, the progress with health care quality assurance is slow. The methodology of development of evidence based guidelines is not accepted. The control over conflict of interest of participants of the development of the guiding documents is not introduced. Economic factors are not systematically addressed in decisions on provision of health care interventions. The practice of the health technology assessment does not exist. The system of financial incentives for the quality of care dominates and is developing without evidence based criteria and evidence of its efficacy. ConclusionThe documents prescribing quality healthcare are developing non-systematically in Russia. The acceptance of the modern methodology of guideline development, health technology assessment and control over conflict of interest is needed as a minimum prerequisite for the progress in the quality assurance.

Promotion of influenza vaccination among health care workers: findings from a tertiary care children's hospital in Italy.

BackgroundThe aims of this study were: a) to evaluate attitudes and practices of health care workers (HCWs) towards influenza vaccination and their opinion regarding a vaccination promotion toolkit; b) to estimate hospital HCWs’ influenza vaccination coverage rates (VC).MethodsThe Bambino Gesù Children’s Hospital (OPBG) is an academic hospital in Italy. Since 2009, free influenza vaccination is offered to HCWs during working hours. In October-December 2013, a communication campaign based on a standardized toolkit was conducted. In December 2013, we performed a cross-sectional survey in a sample of hospital wards, based on a self-administered questionnaire including participants’ characteristics; self-reported influenza vaccination history; reasons for vaccination or missed vaccination; opinion regarding the toolkit. Multivariable logistic analysis was used to assess independent predictors of influenza vaccination status. Annual VC for years 2009–2013 was estimated by using the number of seasonal influenza vaccine doses administered to HCWs as numerator, and the number of hospital HCWs as denominator.ResultsOut of 191 HCWs who participated in the survey, 35.6 % reported at least one influenza vaccination during their life; 6.8 % adhered to annual revaccination. Years of service and professional category were significantly and independently associated with vaccination (adjusted-OR: 2.4 for > 10 years of service, compared to < 5 years of service; adjusted-OR: 2.6 for physicians compared to nurses). Patient protection was the main reported reason for vaccination (34.3 %); considering influenza a mild disease was the main reason for non-vaccination (36.9 %); poor vaccine effectiveness was the main reason for missed annual revaccination (28.8 %). Overall, 75 % of respondents saw at least one promotion tool; 65.6 % of them found the information useful. Hospital VC decreased from 30 % in 2009, to 5 % in 2012. In 2013, VC was 14 %.ConclusionsSatisfactory influenza VC in HCWs is hard to achieve. In 2013, along with the toolkit implementation, we observed an increase in HCWs’ vaccination coverage, nevertheless, it remained unsatisfactory. Tailored information strategies targeting nurses and recently employed HCWs should be implemented. Institution of declination statements, adding influenza vaccination to financial incentive systems, or vaccination requirements should also be considered to increase influenza VC among HCWs.

We Are Still Waiting for Fully Supportive Electronic Health Records in Pediatrics

* Abbreviations: AAP — : American Academy of Pediatrics EHR — : electronic health record MU — : Meaningful Use In this month’s issue of Pediatrics , we read a report on the state of clinical information technology adoption by pediatricians, based on an American Academy of Pediatrics (AAP) survey from 2009.1 The lessons from this report are that pediatricians were not adopting technology as fast as their nonpediatrician counterparts and, just as concerning, they were using technology that is not supportive of basic child health functions. Much has changed since 2009. The irresistible force in the electronic health record (EHR) market is the federal Meaningful Use (MU) program,2 a system of financial incentives funded through the 2009 American Recovery and Reinvestment Act intended to accelerate the adoption of EHRs. Those who work in EHR implementation know that the primary focus of EHR vendors and their customers during the past 2 years has been to modify their systems to meet the MU requirements. The work is not insignificant. A workgroup convened by the National Association of Children’s Hospitals estimated that it took hospitals 500 to 1000 person-hours each to create the functionality and reporting for … Address correspondence to S. Andrew Spooner, MD, MS, FAAP, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC-9009, Cincinnati, OH 45229. E-mail: andrew.spooner{at}cchmc.org

The Persistent Problems and Confounding Challenges of Educator Incentives

While education accountability systems emphasize teacher quality as a prerequisite for student learning, education administrators have struggled to staff low-performing schools with effective teachers. Fueled in part by the federal Teacher Incentive Fund, compensation reforms have gained center stage status among strategies aimed at improving human capital in schools. This article presents findings from a formative evaluation of the initial year of implementation of the Financial Incentive Rewards for Supervisors and Teachers (FIRST) program in the Prince George’s County Public School System. Our review of the relevant theoretical and empirical literature on financial incentive systems in public school systems identified four sets of implementation challenges: securing and maintaining stakeholder support; developing and implementing accurate and credible measures of educator performance; developing the district and site capacity required to implement and sustain the initiative; and aligning the reform with human resource goals, school improvement initiatives, and features of the work environment. Our field research on the formulation, implementation, and initial impact of the FIRST initiative demonstrates that even when an educator incentive initiative reflects “lessons learned” from the empirical and theoretical literature, challenges that undermine the initiative’s potential to realize its major goals persist. We argue that this case extends our understanding of the key challenges identified in the literature and we highlight implications for policy and research.

Modern Technology, Leaky Copyrights and Claims of Harm: Insights from the Curious History of Photocopying

Over the last half century, as each new technology that facilitates private, noncommercial copying of copyrighted works has emerged, segments of the copyright-owning community have predicted destruction of their markets. Not only has this not happened, but in fact it has been quite difficult to substantiate much, or even, any harm to the financial incentive system that copyright supports. The oldest of these technologies is photocopying, and it is also the one that was subject to intense scrutiny over the decades. It makes, therefore, an interesting case study with the potential to throw light on why harm from noncommercial copying has been so difficult to demonstrate. This Article follows the photocopying dispute from its inception, and concludes that virtually all the evidence that was used to support claims of harm to the publishing industry from its use turned out to be from other, often less sympathetic, causes. The Article concludes not only that private and noncommercial copying of text should be given far more generous treatment as a fair use than it currently receives, but that both courts and Congress have reason to scrutinize with far greater rigor than they have shown thus far claims of harm from personal and noncommercial copying using other technologies.

Public science and public innovation: Assessing the relationship between patenting at U.S. National Laboratories and the Bayh-Dole Act

Most studies of the effects of the Bayh-Dole Act have focused on universities. In contrast, we analyze patenting activity at two prominent national laboratories, Sandia National Laboratories and the National Institute of Standards and Technology before and after the enactment of this legislation and the Stevenson-Wydler Act. It appears as though the enactment of Bayh-Dole and the Stevenson-Wydler Act were not sufficient to induce an increase in patenting at these labs. However, the establishment of financial incentive systems, embodied in passage of the Federal Technology Transfer Act, as well as the allocation of internal resources to support technology transfer, stimulated an increase in such activity.

University governance reforms: potential problems of more autonomy?

University governance reforms are very much a reflection of the broader New Public Management reforms that are focusing on increasing efficiency in public organizations. The article deals with how university reform ideas of a generic nature, emphasizing that universities should be treated and reformed like any other public organizations, are important and reflected in specific reform measures. The special empirical focus is on that universities through reforms are changing their formal affiliation to superior ministries in a more autonomous direction, implicating more autonomy in financial, management and decision-making matters. One the other hand, universities are also through reforms more exposed to more report, scrutiny and control systems, financial incentive systems, pressure to get resources from other sources than the government, cut-back management, etc. So a main question in the analysis is whether universities, as traditionally having quite a lot of real autonomy, through the reforms in fact are getting less autonomy, not more, like the reforms entrepreneurs often are promising. The analysis is based on a transformational approach from organization theory, representing a combination of structural, cultural and environmental factors of explanation for reforms processes and their effects. Empirically the article is based on the author’s own empirical studies of university reform and reviews of comparative studies.

Public Science and Public Innovation: Assessing the Relationship between Patenting at U.S. National Laboratories and the Bayh-Dole Act

Most studies of the effects of the Bayh-Dole Act have focused on universities. In contrast, we analyze patenting activity at two prominent national laboratories, Sandia National Laboratories and the National Institute of Standards and Technology before and after the enactment of this legislation and the Stevenson-Wydler Act. It appears as though the enactment of Bayh-Dole and the Stevenson-Wydler Act were not sufficient to induce an increase in patenting at these labs. However, the establishment of financial incentive systems, embodied in passage of the Federal Technology Transfer Act, as well as the allocation of internal resources to support technology transfer, stimulated an increase in such activity.

Inverted risk selection—a structural property of a new population-based integrated care system in Germany

Background and purpose: In the Kinzigtal region in Southwest Germany, a population-based integrative care system has been set up in 2005–2006, organising care across all health service sectors and indications. The system is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians’ network in the region and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Wurttemberg). Membership is optional for insured persons in the Kinzigtal area. In contrast to many other Managed Care organisations, Gesundes Kinzigtal and its partners have intentionally attempted to prevent a policy of risk selection and to organize a better (integrated) care first of all for the so-called ‘bad risks’ such as older persons and the chronically ill. To determine whether that attempt has been successful, we analyse the administrative data of the concerned health insurers during the building phase of the Kinzigtal system (2006–2008). Theory: A common critique of Managed Care initiatives holds that while economic and financial goals have come to dominate, a strat egy of risk selection—i.e. preferred recruitment of the young and/or healthy—has often been forwarded. To overcome this experience, Gesundes Kinzigtal and its partners have set up a specific system of contractual and financial incentives to realize a kind of inverted risk selection, implying the preferred recruitment of the so-called ‘bad risks’. In the contribution we outline the contractual and economic incentives which are to produce an inverted risk selection and a more efficient care in greater detail. Methods: To check whether Gesundes Kinzigtal has managed to realize an inverted risk selection, age, social status and morbidity costs of the insured members of the integrated care network are compared with the data of those assureds in the Kinzigtal region who have not (yet) become members. The contribution will focus on the health insurers’ administrative data that were collected during the whole building phase of the system (2006–2008). Results and conclusions: The available data show that the Kinzigtal integrated care system has indeed managed to realize an inverted risk selection during its building phase (2006–2008), i.e. its members are considerably older and cause remarkably higher morbidity costs than the non-members in that area. Discussion: The contractual and financial incentives of the Kinzigtal system have obviously been adequate means to realize an inverted risk selection. At the same time, the financial results of the first two years (2006–2007) of the system have turned out surprisingly positive (see other abstract)—thus Gesundes Kinzigtal demonstrates the huge potential of population-based integrated care approaches.

The Dynamics and Functions of Self‐Organization in the Fuzzy Front End: Empirical Evidence from the Austrian Semiconductor Industry

This paper studies the functions, impacts and dynamics of self‐organization in the fuzzy front end of innovation. Based on a case study approach, the new product development processes of five Austrian semiconductor companies are analysed. We adopt a complexity science perspective which stresses that self‐organization and emergence are key elements of the new product development process. We found that self‐organization mechanisms occur in two ways. First, self‐organizational activities support formal and top‐down managed new product development processes. In this way, they contribute to the acceleration and adaptation of the new product development process and are also a way to overcome bureaucratic structures. Second, we found evidence for the existence of purely emergent bottom‐up processes in many cases. In this context, employees intrinsically and without any explicit order or strategy took initiatives to innovate. Such activities run in parallel to or precede formal new product development processes and employees deliberately bypass and even ignore formal processes such as financial incentive systems, suggestion schemes and patenting rules in order to promote their ideas. These activities are often secret until they are mature enough to be presented to the management, when they are then, if evaluated positively, incorporated as official projects in the new product development process.

Reassessing the Productivity Impact of Employee Involvement and Financial Incentives

Employee involvement and financial incentives are often praised as effective means for increasing firm productivity. We assess the productivity effects of these human resource practices by accounting for the main sources of estimation bias - unobserved heterogeneity and endogeneity - and by using representative establishment panel data for Germany. We show that employee involvement raises establishment productivity, but financial incentive systems do not. An important result is that accounting for unobserved heterogeneity and endogeneity reverses the conclusions on the estimated productivity effects obtained from simple cross-sectional regressions.

Design of a regulated system of compensation for living kidney donors

The pros and cons of a regulated system of financial incentives for living donors are being actively debated. To date, a detailed proposal on how such a system could work has not been developed. Herein, the specifics of a potential model, using the infrastructure already in place for deceased donor evaluation and allocation, are outlined.

Moving Implementation Science Forward

Moving Implementation Science Forward

Wastewater treatment in Brazil: Institutional framework, recent initiatives and actual plant performance

Brazil, like many other developing countries, suffers from widespread pollution of the aquatic environment caused by the uncontrolled discharge of untreated urban wastewater. Some states have made greater progress towards the implementation of pollution mitigation strategies than others. However, a study undertaken in the states of So Paulo and Minas Gerais indicates that installation of treatment plants is not sufficient to meet effluent quality objectives. A range of different wastewater treatment processes were investigated and, although conclusive results were difficult to define due to the large differences in the frequency of sampling, the results showed a highly variable performance, in which many processes were not operating satisfactorily according to expected design performance or environmental standards set by the regulatory authority. In light of these findings, the paper discusses an innovative programme called PRODES, introduced by the National Water Agency (ANA), which aims to encourage public and private companies to implement new treatment plants and to improve the performance of existing wastewater treatment systems based upon a system of financial incentives according to the monitored reduction in pollutant loads. The paper concludes that this approach has considerable potential as part of a pollution mitigation strategy, but success is dependent on the development of a standardized framework for routine performance evaluation and monitoring to improve operational performance and regulatory procedures.

Energy and building technology for the 2000 W society—Potential of residential buildings in Switzerland

The 2000 W society, achievable through cuts in resource consumption and per capita CO 2 emissions, is closely related to the goals of sustainable development. This study identifies the specific targets that need to be met both globally and by Switzerland to realize the vision. As a major energy consumer, the buildings sector will have to make a substantial contribution to meeting these targets. The report starts by examining the energy-saving potential of individual residential buildings through different combinations of building standard and building services system. Various building concepts already available today offer considerable potential and, as individual solutions, often achieve the targets of the 2000 W society. Yet, as the impact of such individual solutions on the building stock is dampened by a range of factors (e.g. long refurbishment cycles, low energy prices, scepticism of investors towards new technology), the effective gains fall far short of the theoretical potential. As the considered implementation scenarios and building stock projections show, the average buildings-sector targets required for the 2000 W society are nonetheless attainable. However, in order to tap the potential in the residential buildings sector, there is an urgent need for immediate action at various levels (e.g. through financial incentive systems, consumer information campaigns).

Control in a Teamwork Environment—The Impact of Social Ties on the Effectiveness of Mutual Monitoring Contracts

This study examines control in a teamwork setting, experimentally investigating two financial incentive systems that have been proposed in the agency-theory-based analytic literature. Both systems rely on mutual monitoring—the ability of team members to observe each other's actions. However, the systems differ on whether team members report observations of their peers' efforts to management (vertical incentive system) or directly control the actions of each other (horizontal incentive system). Findings suggest that the effectiveness of these systems depends on the level of team identity. Specifically, a strong team identity leads to greater coordination. The result is that the effectiveness of a vertical incentive system is degraded by a strong team identity. On the other hand, a horizontal incentive system becomes more effective in the presence of a strong team identity. The results of this study suggest that when the team has achieved a high level of identity, the most effective way to use this information is likely horizontal in nature, delegating responsibility for control to self-managed teams, rather than extracting the information through reporting mechanisms. This study thus helps explain why firms have more readily embraced horizontal incentive systems than vertical incentive systems.