IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this article or follow this journal

Paying for performance and the social relations of health care provision: An anthropological perspective

  • Magrath, Priscilla
  • Nichter, Mark
Registered author(s):

    Over the past decade, the use of financial incentive schemes has become a popular form of intervention to boost performance in the health sector. Often termed “paying for performance” or P4P, they involve “…the transfer of money or material goods conditional upon taking a measurable action or achieving a predetermined performance target” (Eldridge & Palmer, 2009, p.160). P4P appear to bring about rapid improvements in some measured indicators of provider performance, at least over the short term. However, evidence for the impact of these schemes on the wider health system remains limited, and even where evaluations have been positive, unintended effects have been identified. These have included: “gaming” the system; crowding out of “intrinsic motivation”; a drop in morale where schemes are viewed as unfair; and the undermining of social relations and teamwork through competition, envy or ill feeling. Less information is available concerning how these processes occur, and how they vary across social and cultural contexts.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612005667
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 10 ()
    Pages: 1778-1785

    as
    in new window

    Handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1778-1785
    Contact details of provider: Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description

    Order Information: Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional
    Web: http://www.elsevier.com/orderme/journalorderform.cws_home/315/journalorderform1/orderooc/id=654&ref=654_01_ooc_1&version=01

    References listed on IDEAS
    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

    as in new window
    1. Faguet, Jean-Paul & Ali, Zulfiqar, 2009. "Making Reform Work: Institutions, Dispositions, and the Improving Health of Bangladesh," World Development, Elsevier, vol. 37(1), pages 208-218, January.
    2. Gilson, Lucy & Palmer, Natasha & Schneider, Helen, 2005. "Trust and health worker performance: exploring a conceptual framework using South African evidence," Social Science & Medicine, Elsevier, vol. 61(7), pages 1418-1429, October.
    3. Rena Eichler & Paul Auxila & Uder Antoine & Bernateau Desmangles, 2007. "Performance-Based Incentives for Health: Six Years of Results from Supply-Side Programs in Haiti," Working Papers 121, Center for Global Development.
    4. Harvey, David, 2007. "A Brief History of Neoliberalism," OUP Catalogue, Oxford University Press, number 9780199283279, March.
    5. Nichter, Mark A., 1986. "The primary health center as a social system: PHC, social status, and the issue of team-work in South Asia," Social Science & Medicine, Elsevier, vol. 23(4), pages 347-355, January.
    6. Mark Shenkin & Andrea B. Coulson, 2007. "Accountability through activism: learning from Bourdieu," Accounting, Auditing & Accountability Journal, Emerald Group Publishing, vol. 20(2), pages 297-317, February.
    7. Ssengooba, Freddie & McPake, Barbara & Palmer, Natasha, 2012. "Why performance-based contracting failed in Uganda – An “open-box” evaluation of a complex health system intervention," Social Science & Medicine, Elsevier, vol. 75(2), pages 377-383.
    8. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    9. Nichter, Mark, 1983. "Paying for what ails you: Sociocultural issues influencing the ways and means of therapy payment in South India," Social Science & Medicine, Elsevier, vol. 17(14), pages 957-965, January.
    10. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth, 2002. "Health sector reform and public sector health worker motivation: a conceptual framework," Social Science & Medicine, Elsevier, vol. 54(8), pages 1255-1266, April.
    Full references (including those not matched with items on IDEAS)

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1778-1785. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei)

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.