Physician Financial Incentives for Use of Outpatient Intravenous Antimicrobial Therapy: An Interrupted Time Series Analysis.

This article evaluates the impact of a 2011 policy in British Columbia that introduced a fee-for-service billing code (G33655) to incentivize infectious diseases (ID) specialist physicians to supervise outpatient parenteral antimicrobial therapy (OPAT). Using a 14-year retrospective cohort and interrupted time series analysis, the study found no significant increase in OPAT use—measured by the proportion of hospitalizations with length of stay shorter than the usual duration of intravenous antimicrobials—following the policy's introduction. Although the policy was associated with increased payments to ID physicians and a modest rise in the number of ID specialists involved in care, it did not translate into expanded OPAT utilization. The findings suggest that financial incentives alone may be insufficient to increase OPAT use without addressing other organizational or systemic barriers.