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Performance-based financing as a health system reform: mapping the key dimensions for monitoring and evaluation.
- BMC Health Serv Res
, 2013
"... Abstract Background: Performance-based financing is increasingly being applied in a variety of contexts, with the expectation that it can improve the performance of health systems. However, while there is a growing literature on implementation issues and effects on outputs, there has been relativel ..."
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Abstract Background: Performance-based financing is increasingly being applied in a variety of contexts, with the expectation that it can improve the performance of health systems. However, while there is a growing literature on implementation issues and effects on outputs, there has been relatively little focus on interactions between PBF and health systems and how these should be studied. This paper aims to contribute to filling that gap by developing a framework for assessing the interactions between PBF and health systems, focusing on low and middle income countries. In doing so, it elaborates a general framework for monitoring and evaluating health system reforms in general.
Provider Payment Methods and Incentives
, 2007
"... selection, capitation, incentives, risk adjustment. Diverse provider payment systems create incentives that affect the quantity and quality of health care services provided. Payments can be based on provider characteristics, which tend to minimize incentives for quality and quantity. Or payments can ..."
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selection, capitation, incentives, risk adjustment. Diverse provider payment systems create incentives that affect the quantity and quality of health care services provided. Payments can be based on provider characteristics, which tend to minimize incentives for quality and quantity. Or payments can be based on quantities of services provided and patient characteristics, which provide stronger incentives for quality and quantity. Payments methods using both broader bundles of services and larger numbers of payment categories are growing in prevalence. The recent innovation of performance-based payment attempts to target payments on key patient attributes so as to improve incentives, better manage patients, and control costs. 2 There are many ways that health care providers can be paid. In India, government physicians are paid a salary and in Canada physicians are generally paid according to a government-regulated fee schedule. In the Netherlands however, office-based physicians receive capitated payments for much of their revenue. Similar variations are seen in
Eff ect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation
"... Summary Background Evidence about the best methods with which to accelerate progress towards achieving the Millennium Development Goals is urgently needed. We assessed the eff ect of performance-based payment of health-care providers (payment for performance; P4P) on use and quality of child and ma ..."
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Summary Background Evidence about the best methods with which to accelerate progress towards achieving the Millennium Development Goals is urgently needed. We assessed the eff ect of performance-based payment of health-care providers (payment for performance; P4P) on use and quality of child and maternal care services in health-care facilities in Rwanda.
Financial Incentives are Counterproductive in Non-Profit Sectors: Evidence from a Health Experiment *
"... Abstract Financial incentives for service providers are becoming a common strategy to improve service delivery. However, this strategy will only work if demand for the service responds as expected. Using a field experiment in the Democratic Republic of Congo, we show that introducing a performance- ..."
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Abstract Financial incentives for service providers are becoming a common strategy to improve service delivery. However, this strategy will only work if demand for the service responds as expected. Using a field experiment in the Democratic Republic of Congo, we show that introducing a performance-based financing mechanism in the health sector has counterproductive effects because demand is non-standard: despite reduced prices and eased access, demand for health decreased, child health deteriorated, workers' revenue dropped. Ironically, expected perverse effects of incentives on worker behavior were not realized: incentives led to more effort from health workers on rewarded activities without deterring effort on non-rewarded activities, nor inducing significant score manipulation or free-riding. We also find a decline in worker motivation following the removal of the incentives, below what it would have been in the absence of exposure to the incentives. Management tools used in for-profit sectors are thus inappropriate in non-profit sectors such as health where user and worker rationalities are specific.
unknown title
, 2009
"... doi:10.1093/heapol/czq009 Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries ..."
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doi:10.1093/heapol/czq009 Direct facility funding as a response to user fee reduction: implementation and perceived impact among Kenyan health centres and dispensaries
Implementation Science STUDY PROTOCOL Open Access
"... for improving malaria management in rural Kenya: protocol for a cluster randomized controlled trial ..."
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for improving malaria management in rural Kenya: protocol for a cluster randomized controlled trial
STUDY PROTOCOL Protocol
"... for the evaluation performance programme f te Implementation Science Borghi et al. Implementation Science 2013, 8:80 ..."
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for the evaluation performance programme f te Implementation Science Borghi et al. Implementation Science 2013, 8:80
Performance-based Contracting: a Case Study of Non-profit Hospitals in Uganda.
"... I Freddie Peter Ssengooba confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. 2 Acknowledgements Gratitude go to London University for its contribution to my education and to the UK&apo ..."
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I Freddie Peter Ssengooba confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. 2 Acknowledgements Gratitude go to London University for its contribution to my education and to the UK's DFID for its financial support for the knowledge programmes in particular, the Health System Development Programme at London School of Hygiene and Tropical Medicine (LSHTM) which enabled me to undertake this study. Tremendous thanks go to Makerere University and its School of Public Health for allowing me the time to undertake this study. I am very honoured for the teachings, kindnesses, and advice of some of the very best in this academic field. Most gratitude go to my Supervisors Dr. Natasha Palmer and Prof. Barbara Isobel McPake and to the staff and fellow students of Dept. of Global Health and Development (GHD)- formally Health Policy Unit at LSHTM for the enduring support and
for Programme Managers
, 2009
"... This is a working document. It has been prepared to facilitate the exchange of knowledge and to stimulate discussion. The text has not been edited to official publication standards and UNICEF accepts no responsibility for errors. The designations in this publication do not imply an opinion on legal ..."
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This is a working document. It has been prepared to facilitate the exchange of knowledge and to stimulate discussion. The text has not been edited to official publication standards and UNICEF accepts no responsibility for errors. The designations in this publication do not imply an opinion on legal status of any country or territory, or of its authorities, or the delimitation of frontiers.
reduction: implementation and perceived
, 2009
"... Direct facility funding as a response to user fee ..."
