Capitation Combined with Pay-for-Performance Improves Antibiotic Prescribing Practices in Rural China

Yip, Winnie; Powell‐Jackson, Timothy; Chen, Wen; Hu, Min; Fe, Eduardo; Hu, Mu; Jian, Weiyan; Lu, Ming; Han, Wei; Hsiao, William C.

doi:10.1142/9789813236134_0008

Cited by 17 publications

(31 citation statements)

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“…Performance-based financing might modestly improve quality compared with no intervention in some contexts, but does not always outperform unconditional financing; the effect appears to be driven not by the financing mechanism as much as the equipment and workforce interventions. [314][315][316][317] Compared with alternative interventions, performance-based financing incurs unique costs for performance verification that can account for 10% to 15% of operating costs, including the cost of staff time. 318 There can also be unintended consequences of performance-based financing programmes, including reports that providers have threatened patients to report positive outcomes, but these programmes can also…”

Section: The Lancet Global Health Commissionmentioning

confidence: 99%

High-quality health systems in the Sustainable Development Goals era: time for a revolution

Kruk

Gage

Arsenault

et al. 2018

The Lancet Global Health

2,245

2,275

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The Lancet Global Health Commission and respecting all workers to deliver the best care possible. Fourth, governments and civil society should ignite demand for quality in the population to empower people to hold systems accountable and actively seek high-quality care. Additional targeted actions in areas such as health financing, management, district-level learning, and others can complement these efforts. What works in one setting might not work elsewhere, and improvement efforts should be adapted for local context and monitored. Funders should align their support with system-wide strategies rather than contribute to the proliferation of micro-level efforts. In this Commission, we assert that providing health services without guaranteeing a minimum level of quality is ineffective, wasteful, and unethical. Moving to a highquality health system-one that improves health and generates confidence and economic benefits-is primarily a political, not technical, decision. National governments need to invest in high-quality health systems for their own people and make such systems accountable to people through legislation, education about rights, regulation, transparency, and greater public participation. Countries will know that they are on the way towards a high-quality, accountable health system when health workers and policymakers choose to receive health care in their own public institutions. Components Quality impacts Better health Level and distribution of patient-reported outcomes: function, symptoms, pain, wellbeing, quality of life, and avoiding serious health-related suffering Confidence in system Satisfaction, recommendation, trust, and care uptake and retention Economic benefit Ability to work or attend school, economic growth, reduction in health system waste, and financial risk protection Processes of care Competent care and systems Evidence-based, effective care: systematic assessment, correct diagnosis, appropriate treatment, counselling, and referral; capable systems: safety, prevention and detection, continuity and integration, timely action, and population health management Positive user experience Respect: dignity, privacy, non-discrimination, autonomy, confidentiality, and clear communication; user focus: choice of provider, short wait times, patient voice and values, affordability, and ease of use Foundations Population Individuals, families, and communities as citizens, producers of better health outcomes, and system users: health needs, knowledge, health literacy, preferences, and cultural norms Governance Leadership: political commitment, change management; policies: regulations, standards, norms, and policies for the public and private sector, institutions for accountability, supportive behavioural architecture, and public health functions; financing: funding, fund pooling, insurance and purchasing, provider contracting and payment; learning and improvement: institutions for evaluation, measurement, and improvement, learning communities, and trustworthy data; intersectoral: roads, transport, wa...

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Section: The Lancet Global Health Commissionmentioning

confidence: 99%

High-quality health systems in the Sustainable Development Goals era: time for a revolution

Kruk

Gage

Arsenault

et al. 2018

The Lancet Global Health

2,245

2,275

View full text Add to dashboard Cite

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“…Antimicrobial resistance (AMR) is a serious public health problem threatening to undermine modern medicine [1]. Prescribing and consumption of antibiotics is a key driver of resistance and there have been a number of antimicrobial stewardship programs (pay-for-performance, educational, audits, and guidelines) implemented in different countries with the intention of reducing inappropriate antimicrobial prescribing [2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

An Assessment of Potential Unintended Consequences Following a National Antimicrobial Stewardship Program in England: An Interrupted Time Series Analysis

Balinskaite¹,

Bou-Antoun

Johnson

et al. 2018

Clinical Infectious Diseases

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Background The “Quality Premium” (QP) introduced in England in 2015 aimed to financially reward local healthcare commissioners for targeted reductions in primary care antibiotic prescribing. We aimed to evaluate possible unintended clinical outcomes related to this QP. Methods Using Clinical Practice Research Datalink and Hospital Episode Statistics datasets, we examined general practitioner (GP) consultations (visits) and emergency hospital admissions related to a series of predefined conditions of unintended consequences of reduced prescribing. Monthly age- and sex-standardized rates were calculated using a direct method of standardization. We used segmented regression analysis of interrupted time series to evaluate the impact of the QP on seasonally adjusted outcome rates. Results We identified 27334 GP consultations and >5 million emergency hospital admissions with predefined conditions. There was no evidence that the QP was associated with changes in GP consultation and hospital admission rates for the selected conditions combined. However, when each condition was considered separately, a significant increase in hospital admission rates was noted for quinsy, and significant decreases were seen for hospital-acquired pneumonia, scarlet fever, pyelonephritis, and complicated urinary tract conditions. A significant decrease in GP consultation rates was estimated for empyema and scarlet fever. No significant changes were observed for other conditions. Conclusions Findings from this study show that overall there was no significant association between the intervention and unintended clinical consequences, with the exception of a few specific conditions, most of which could be explained through other parallel policy changes or should be interpreted with caution due to small numbers.

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“…30 Recently the country has explored alternative payment methods. In one experiment, 31 one group of health centers was left being paid fee-for-service while the other group was switched to a mix of capitated global budget and performance-related payments based on the appropriateness of drug prescribing and patient satisfaction. The blended approach led to less antibiotic use and lower patient out-of-pocket expenditures.…”

Section: Deon Filmer and Adam Wagstaffmentioning

confidence: 99%

Toward Successful Development Policies: Insights from Research in Development Economics

Artuç

Cull

Dasgupta

et al. 2020

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Capitation Combined with Pay-for-Performance Improves Antibiotic Prescribing Practices in Rural China

Cited by 17 publications

References 0 publications

High-quality health systems in the Sustainable Development Goals era: time for a revolution

High-quality health systems in the Sustainable Development Goals era: time for a revolution

An Assessment of Potential Unintended Consequences Following a National Antimicrobial Stewardship Program in England: An Interrupted Time Series Analysis

Toward Successful Development Policies: Insights from Research in Development Economics

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