BMJ 1997;315:703-707 (20 September)
Papers
Should we pay the patient? Review of financial incentives to enhance patient compliance
Antonio Giuffrida,
research
fellow,a
David J Torgerson,
research
fellow aa National Primary Care Research and Development Centre, Centre for Health Economics, University of York, York YO1 5DD
Correspondence to: Mr Giuffrida agia@York.ac.uk
Objective: To determine whether financial
incentives increase patients' compliance with healthcare treatments.
Data sources: Systematic literature review of
computer databasesMedline, Embase, PsychLit, EconLit, and the Cochrane Database
of Clinical Trials. In addition, the reference list of each retrieved article was reviewed and
relevant citations retrieved.
Study selection: Only randomised trials with
quantitative data concerning the effect of financial incentives (cash, vouchers, lottery tickets, or
gifts) on compliance with medication, medical advice, or medical appointments were included
in the review. Eleven papers were identified as meeting the selection criteria.
Data extraction: Data on study populations,
interventions, and outcomes were extracted and analysed using odds ratios and the number of
patients needed to be treated to improve compliance by one patient.
Results: 10 of the 11 studies showed improvements
in patient compliance with the use of financial incentives.
Conclusions: Financial incentives can improve
patient compliance.
|
Key messages
- Non-compliance with medical treatment is a widespread problem
- Non-compliance may lead to increased treatment costs in future
- Financial incentives can significantly reduce non-compliance
- Incentives can be cost effective, particularly for treatment of infectious disease
- Research in the context of the United Kingdom is required
|

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