IDEAS home Printed from https://ideas.repec.org/h/wsi/wschap/9789813272378_0006.html
   My bibliography  Save this book chapter

Paying for Performance for Health Care in Low- and Middle-Income Countries: An Economic Perspective

In: Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries

Author

Listed:
  • Martin Chalkley
  • Andrew J. Mirelman
  • Luigi Siciliani
  • Marc Suhrcke
  • Peter Berman

Abstract

Pay-for-performance (P4P) arrangements, which are fixtures of health systems in high-income countries (HIC), have been deployed across many low- and middle-income country (LMIC) settings as well. P4P programmes in HICs have typically addressed the challenge of over-delivery, controlling costs while maintaining adequate services and getting the best clinical practice, or quality of care. In LMICs, health systems are similarly concerned with issues of quality, but they may also grapple with problems of low demand, lack of resources and poor governance. By revisiting the overall framework for understanding P4P arrangements and their benefits and risks in the context of health care delivery, this chapter draws on experiences with P4P in HIC to assess how the insights from economic theory apply in practice in LMICs. Issues of programme design and unintended consequences are summarized, and LMIC case examples of where these concepts apply and are missing from the evidence of P4P programmes in LMIC settings are also reviewed. The evidence on P4P in LMICs is still in its infancy, both in terms of evidence of impact (especially as far as health outcomes are concerned), and in terms of the attention to potential unintended consequences. However, it is critical to return to the basic economic understanding of how the contractual arrangements and incentives of P4P inform programme design and ultimately impact health outcomes and service delivery.

Suggested Citation

  • Martin Chalkley & Andrew J. Mirelman & Luigi Siciliani & Marc Suhrcke & Peter Berman, 2020. "Paying for Performance for Health Care in Low- and Middle-Income Countries: An Economic Perspective," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 6, pages 157-190, World Scientific Publishing Co. Pte. Ltd..
  • Handle: RePEc:wsi:wschap:9789813272378_0006
    as

    Download full text from publisher

    File URL: https://www.worldscientific.com/doi/pdf/10.1142/9789813272378_0006
    Download Restriction: Ebook Access is available upon purchase.

    File URL: https://www.worldscientific.com/doi/abs/10.1142/9789813272378_0006
    Download Restriction: Ebook Access is available upon purchase.
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Bonfrer, Igna & Van de Poel, Ellen & Van Doorslaer, Eddy, 2014. "The effects of performance incentives on the utilization and quality of maternal and child care in Burundi," Social Science & Medicine, Elsevier, vol. 123(C), pages 96-104.
    2. Laurence Lannes & Bruno Meessen & Agnes Soucat & Paulin Basinga, 2016. "Can performance-based financing help reaching the poor with maternal and child health services? The experience of rural Rwanda," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 309-348, July.
    3. Oddvar Kaarboe & Luigi Siciliani, 2011. "Multi‐tasking, quality and pay for performance," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 225-238, February.
    4. Ellen Van de Poel & Gabriela Flores & Por Ir & Owen O'Donnell, 2016. "Impact of Performance‐Based Financing in a Low‐Resource Setting: A Decade of Experience in Cambodia," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 688-705, June.
    5. Michael Kuhn & Luigi Siciliani, 2009. "Performance Indicators for Quality with Costly Falsification," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 18(4), pages 1137-1154, December.
    6. Xiaojie Sun & Xiaoyun Liu & Qiang Sun & Winnie Yip & Adam Wagstaff & Qingyue Meng, 2016. "The Impact of a Pay‐for‐Performance Scheme on Prescription Quality in Rural China," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 706-722, June.
    7. Leemore S. Dafny, 2005. "How Do Hospitals Respond to Price Changes?," American Economic Review, American Economic Association, vol. 95(5), pages 1525-1547, December.
    8. Edward N. Okeke & Amalavoyal V. Chari, 2015. "Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda," Working Papers 1072, RAND Corporation.
    9. Eggleston, Karen, 2005. "Multitasking and mixed systems for provider payment," Journal of Health Economics, Elsevier, vol. 24(1), pages 211-223, January.
    10. Grittner, Amanda Melina, 2013. "Results-based financing: evidence from performance-based financing in the health sector," Discussion Papers 6/2013, German Development Institute / Deutsches Institut für Entwicklungspolitik (DIE).
    11. Ferdinando Regalía & Leslie Castro, 2007. "Performance-based Incentives for Health: Demand- and Supply-Side Incentives in the Nicaraguan Red de Protección Social," Working Papers 119, Center for Global Development.
    12. Kenneth L. Leonard & Melkiory C. Masatu, 2010. "Professionalism and the know‐do gap: exploring intrinsic motivation among health workers in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 19(12), pages 1461-1477, December.
    13. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    14. Le Grand, Julian, 2003. "Motivation, Agency, and Public Policy: Of Knights and Knaves, Pawns and Queens," OUP Catalogue, Oxford University Press, number 9780199266999.
    15. Benjamin Loevinsohn, 2008. "Performance-Based Contracting for Health Services in Developing Countries : A Toolkit," World Bank Publications - Books, The World Bank Group, number 6481.
    16. Eijkenaar, Frank & Emmert, Martin & Scheppach, Manfred & Schöffski, Oliver, 2013. "Effects of pay for performance in health care: A systematic review of systematic reviews," Health Policy, Elsevier, vol. 110(2), pages 115-130.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Wiktoria Tafesse & Gerald Manthalu & Martin Chalkley, 2019. "The effect of government contracting with faith-based health care providers in Malawi," Working Papers 167cherp, Centre for Health Economics, University of York.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Domenico Lisi & Luigi Siciliani & Odd Rune Straume, 2020. "Hospital competition under pay‐for‐performance: Quality, mortality, and readmissions," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 29(2), pages 289-314, April.
    2. Singh, Neha S. & Kovacs, Roxanne J. & Cassidy, Rachel & Kristensen, Søren R. & Borghi, Josephine & Brown, Garrett W., 2021. "A realist review to assess for whom, under what conditions and how pay for performance programmes work in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 270(C).
    3. Alex Proshin & Adrian Rohit Dass & Lise Rochaix & Audrey Laporte, 2020. "Impact of Quality-Based Procedures on Orthopedic Care Quantity and Quality in Ontario Hospitals," Working Papers 200002, Canadian Centre for Health Economics.
    4. Maija Halonen-Akatwijuka & Carol Propper, 2012. "Competition, Equity and Quality in Health Care," The Centre for Market and Public Organisation 12/296, The Centre for Market and Public Organisation, University of Bristol, UK.
    5. repec:nip:nipewp:10/2014 is not listed on IDEAS
    6. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2017. "Hospital Mergers with Regulated Prices," Scandinavian Journal of Economics, Wiley Blackwell, vol. 119(3), pages 597-627, July.
    7. Karen S Palmer & Thomas Agoritsas & Danielle Martin & Taryn Scott & Sohail M Mulla & Ashley P Miller & Arnav Agarwal & Andrew Bresnahan & Afeez Abiola Hazzan & Rebecca A Jeffery & Arnaud Merglen & Ahm, 2014. "Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-1, October.
    8. Mak, Henry Y., 2018. "Managing imperfect competition by pay for performance and reference pricing," Journal of Health Economics, Elsevier, vol. 57(C), pages 131-146.
    9. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2018. "Can Competition Reduce Quality?," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 174(3), pages 421-447, September.
    10. Jurgita Januleviciute & Jan Erik Askildsen & Oddvar Kaarboe & Luigi Siciliani & Matt Sutton, 2016. "How do Hospitals Respond to Price Changes? Evidence from Norway," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 620-636, May.
    11. Jacky MATHONNAT & Aurore PELISSIER, 2017. "How a Results-Based Financing approach can contribute to the health Sustainable Development Goals - Policy-oriented lessons: what we know, what we need to know and don’t yet know," Working Papers P204, FERDI.
    12. Ma, Ching-to Albert & Mak, Henry Y., 2015. "Information disclosure and the equivalence of prospective payment and cost reimbursement," Journal of Economic Behavior & Organization, Elsevier, vol. 117(C), pages 439-452.
    13. Kuhn, Michael & Siciliani, Luigi, 2008. "Upcoding and Optimal Auditing in Health Care (or The economics of DRG creep)," CEPR Discussion Papers 6689, C.E.P.R. Discussion Papers.
    14. Gil Shapira & Ina Kalisa & Jeanine Condo & James Humuza & Cathy Mugeni & Denis Nkunda & Jeanette Walldorf, 2018. "Going beyond incentivizing formal health providers: Evidence from the Rwanda Community Performance‐Based Financing program," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 2087-2106, December.
    15. Fichera, Eleonora & Anselmi, Laura & Gwati, Gwati & Brown, Garrett & Kovacs, Roxanne & Borghi, Josephine, 2021. "Can Results-Based Financing improve health outcomes in resource poor settings? Evidence from Zimbabwe," Social Science & Medicine, Elsevier, vol. 279(C).
    16. Kuhn, Michael & Siciliani, Luigi, 2013. "Manipulation and auditing of public sector contracts," European Journal of Political Economy, Elsevier, vol. 32(C), pages 251-267.
    17. Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2012. "Quality competition with profit constraints," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 642-659.
    18. Nuscheler, Robert & Roeder, Kerstin, 2015. "Financing and funding health care: Optimal policy and political implementability," Journal of Health Economics, Elsevier, vol. 42(C), pages 197-208.
    19. Bäuml, Matthias & Kümpel, Christian, 2020. "Hospital responses to the introduction of reimbursements by treatment intensity in a (presumably lump sum) DRG system," hche Research Papers 2020/22, University of Hamburg, Hamburg Center for Health Economics (hche).
    20. Vomhof, Markus, 2016. "Hospital competition with heterogeneous patient groups: Incentives and regulation," Ruhr Economic Papers 624, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    21. Schwierz, Christoph & Wübker, Ansgar & Kuchinke, Björn A., 2009. "The Impact of Private versus Social Health Insurance on Offered Waiting Times in German Acute Care Hospitals," Ruhr Economic Papers 120, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

    More about this item

    Keywords

    Global Health; Economics; Economic Evaluation; Cost-Effectiveness; Health Systems; Centre for Health Economics (CHE); University of York;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wsi:wschap:9789813272378_0006. 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: . General contact details of provider: http://www.worldscientific.com/page/worldscibooks .

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Tai Tone Lim (email available below). General contact details of provider: http://www.worldscientific.com/page/worldscibooks .

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.