Effectiveness of altered incentives in a food safety inspection program.

BACKGROUND The Los Angeles County Department of Health Services revamped its retail food establishment inspection program in 1998 to include, among other novel provisions, the prominent posting of grades. The purpose of the present study is to examine results from the second year of the revamped program to determine the longer-term impact of the program. METHODS An analysis of program results for Year 1 led to several program refinements: stratification of risk categories, certification of food handlers, and an external fraud hotline. Outcome measures used included routine inspection scores; closure rates; scores from owner-initiated inspections and departmentally initiated inspections; inspection frequencies; compliance with food handler certification requirements; and frequency of use of the external fraud hotline. RESULTS Inspection scores continued to increase in 1999, while the rate of closures decreased. The owner-initiated inspections also resulted in improved scores, generally maintained on subsequent inspections. Higher risk establishments were inspected more frequently than were lower risk establishments. Over 30,000 food handlers were certified. The external fraud hotline received 16 fraud complaints. CONCLUSIONS Results indicate that retail food establishments are taking stronger action to assure compliance with food safety practices.