دورية أكاديمية
Does pay-for-performance design matter? Evidence from Brazil.
| العنوان: | Does pay-for-performance design matter? Evidence from Brazil. |
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| المؤلفون: | Russo LX; Faculty of Business, Accounting and Economics, Federal University of Grande Dourados, Rodovia Dourados-Itahum, Km 12, Dourados, MS 79804-970, Brazil., Powell-Jackson T; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom., Borghi J; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom., Sampaio J; Department of Health Promotion, Federal University of Paraiba, João Pessoa 58051-900, Brazil., Gurgel Junior GD; Oswaldo Cruz Foundation, Recife 50740-465, Brazil., Shimizu HE; Department of Collective Health, University of Brasilia, Brasilia 70910-900, Brazil., Bezerra AFB; Department of Social Medicine, Federal University of Pernambuco, Recife 50670-901, Brazil., E Silva KSB; Collective Health Nucleous, Academic Center of Vitória, Federal University of Pernambuco, Vitória de Santo Antão 55608-680, Brazil., Barreto JOM; Oswaldo Cruz Foundation, Brasília 70904-130, Brazil., de Carvalho ALB; Department of Health Promotion, Federal University of Paraiba, João Pessoa 58051-900, Brazil., Kovacs RJ; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom., Gomes LB; Department of Health Promotion, Federal University of Paraiba, João Pessoa 58051-900, Brazil., Fardousi N; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom., da Silva EN; Faculty of Ceilândia, University of Brasilia, Brasilia 72220-275, Brazil. |
| المصدر: | Health policy and planning [Health Policy Plan] 2024 Jun 03; Vol. 39 (6), pp. 593-602. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press in association with the London School of Hygiene and Tropical Medicine Country of Publication: England NLM ID: 8610614 Publication Model: Print Cited Medium: Internet ISSN: 1460-2237 (Electronic) Linking ISSN: 02681080 NLM ISO Abbreviation: Health Policy Plan Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Oxford] : Oxford University Press in association with the London School of Hygiene and Tropical Medicine, c1986- |
| مواضيع طبية MeSH: | Reimbursement, Incentive* , Primary Health Care*/economics, Brazil ; Humans ; Quality of Health Care ; Health Services Accessibility/economics |
| مستخلص: | Pay-for-performance (P4P) schemes have been shown to have mixed effects on health care outcomes. A challenge in interpreting this evidence is that P4P is often considered a homogenous intervention, when in practice schemes vary widely in their design. Our study contributes to this literature by providing a detailed depiction of incentive design across municipalities within a national P4P scheme in Brazil [Primary Care Access and Quality (PMAQ)] and exploring the association of alternative design typologies with the performance of primary health care providers. We carried out a nation-wide survey of municipal health managers to characterize the scheme design, based on the size of the bonus, the providers incentivized and the frequency of payment. Using OLS regressions and controlling for municipality characteristics, we examined whether each design feature was associated with better family health team (FHT) performance. To capture potential interactions between design features, we used cluster analysis to group municipalities into five design typologies and then examined associations with quality of care. A majority of the municipalities included in our study used some of the PMAQ funds to provide bonuses to FHT workers, while the remaining municipalities spent the funds in the traditional way using input-based budgets. Frequent bonus payments (monthly) and higher size bonus allocations (share of 20-80%) were strongly associated with better team performance, while who within a team was eligible to receive bonuses did not in isolation appear to influence performance. The cluster analysis showed what combinations of design features were associated with better performance. The PMAQ score in the 'large bonus/many workers/high-frequency' cluster was 8.44 points higher than the 'no bonus' cluster, equivalent to a difference of 21.7% in the mean PMAQ score. Evidence from our study shows how design features can potentially influence health provider performance, informing the design of more effective P4P schemes. (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.) |
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| معلومات مُعتمدة: | Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE); Newton Fund; Fundação de Amparo à Pesquisa do Distrito Federal (FAP-DF); Conselho Nacional das Fundações Estaduais de Amparo à Pesquisa; Fundação de Apoio à Pesquisa do Estado da Paraíba (FAPESQ); United Kingdom MRC_ Medical Research Council; Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE); Newton Fund; Fundação de Amparo à Pesquisa do Distrito Federal (FAP-DF); Conselho Nacional das Fundações Estaduais de Amparo à Pesquisa; Fundação de Apoio à Pesquisa do Estado da Paraíba (FAPESQ); United Kingdom MRC_ Medical Research Council |
| فهرسة مساهمة: | Keywords: Brazil; PMAQ; Pay-for-performance; design features; incentive typology; primary care |
| تواريخ الأحداث: | Date Created: 20240425 Date Completed: 20240603 Latest Revision: 20240605 |
| رمز التحديث: | 20240605 |
| مُعرف محوري في PubMed: | PMC11145906 |
| DOI: | 10.1093/heapol/czae025 |
| PMID: | 38661300 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1460-2237 |
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| DOI: | 10.1093/heapol/czae025 |