Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues

Chaix-Couturier, Carine; Durand‐Zaleski, Isabelle; Jolly, Daniel; Durieux, Pierre

doi:10.1093/intqhc/12.2.133

Cited by 274 publications

(188 citation statements)

References 13 publications

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…Our results mirror findings in Ghana where an additional duty hours allowance which had been initially successful in reducing demotivation became unsustainable, leading to resentment amongst those who had begun to rely on it (Ruwoldt, Perry, Yumkella, & Sagoe, 2007). Financial incentives therefore need to be clear and to work consistently on a local organisational level and as complex incentive structures tend to be less successful (Chaix-Couturier, Durand-Zaleski, Jolly, & Durieux, 2000), key to motivation is ensuring that workers understand the relationship between what is expected from them, how this will be monitored and how this will be rewarded (Chernichovsky & Bayulken, 1995;Giacomini, Hurley, Lomas, Bhatia, & L., 1996). On a broader level, caution must be taken in considering long-term commitments of incentive payments, the effect on intrinsic healthworker motivation (Berwick, 1995) and on the entire health and public service system (Adams & Hicks, 2000).…”

Section: Discussionmentioning

confidence: 99%

Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians

Chandler

Chonya

Mtei

et al. 2009

Social Science & Medicine

128

158

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians

Chandler

Chonya

Mtei

et al. 2009

Social Science & Medicine

128

158

View full text Add to dashboard Cite

show abstract

“…Fourthly, apart from the cost-containment and quality of care issues, capitation payment has the potential to incentivise managers of health facilities to keep to the optimal staffing levels in order to save cost and thereby help address the equity issues in the distribution of hu-man resource for health 52 by re-distributing "excess" staff to underserved areas.…”

Section: Lessons Learnedmentioning

confidence: 99%

A narrative synthesis of illustrative evidence on effects of capitation payment for primary care: lessons for Ghana and other low/middle-income countries

Andoh-Adjei¹,

Spaan²,

Asante³

et al. 2017

Ghana Medical Journal

View full text Add to dashboard Cite

SUMMARYObjective: To analyse and synthesize available international experiences and information on the motivation for, and effects of using capitation as provider payment method in country health systems and lessons and implications for low/middle-income countries. Methods: We did narrative review and synthesis of the literature on the effects of capitation payment on primary care. Results: Eleven articles were reviewed. Capitation payment encourages efficiency: drives down cost, serves as critical source of income for providers, promotes adherence to guidelines and policies, encourages providers to work better and give health education to patients. It, however, induces reduction in the quantity and quality of care provided and encourages skimming on inputs, underserving of patients in bad state of health, "dumping" of high risk patients and negatively affect patient-provider relationship. Conclusion:The illustrative evidence adduced from the review demonstrates that capitation payment in primary care can create positive incentives but could also elicit un-intended effects. However, due to differences in country context, policy makers in Ghana and other low/middle-income countries may only be guided by the illustrative evidence in their design of a context-specific capitation payment for primary care.

show abstract

“…The criteria were as follows: (1) is there a well-defined question; (2) is there a defined search strategy; (3) are inclusion/exclusion criteria stated; (4) are study designs and number of studies clearly stated; (5) have the primary studies been quality assessed; (6) have the studies been appropriately synthesised; (7) has more than one author been involved in each stage of the review process. Reviews were categorised as low (met 0-3 criteria), medium (4-5) or high (6)(7) quality.…”

Section: Data Extraction and Quality Appraisalmentioning

confidence: 99%

All Things Being Equal: Does it Matter for Equity How You Organize and Pay for Health Care? A Review of the International Evidence

Bambra¹,

Garthwaite²,

Hunter³

2014

Int J Health Serv

View full text Add to dashboard Cite

Over the last 25 years, the health care systems of most high-income countries have experienced extensive—usually market-based—organizational and financial reforms. The impact of these system changes on health equity has been hotly debated. Examining evidence from systematic reviews of the effects of health care system organizational and financial reforms will add empirical information to this debate, identify any evidence gaps, and help policy development. Systematic review methodology was used to locate and evaluate published systematic reviews of quantitative intervention studies (experimental and observational) of the effects on equity in health care access and/or health status of health care system organizational and financial reforms (system financing, funding allocations, direct purchasing arrangements, organization of service provision, and health and social care system integration) in high-income countries. Nine systematic reviews were identified. Private insurance and out-of-pocket payments as well as the marketization and privatization of services have either negative or inconclusive equity effects. The evidence base on the health equity effects of managed care programs or integrated partnerships between health and social services is inconclusive. There were no relevant studies located that related to resource allocation reforms. The systematic review-level evidence base suggests that financial and organizational health care system reforms have had either inconclusive or negative impacts on health equity both in terms of access relative to need and in terms of health outcomes.

show abstract

Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues

Abstract: Financial incentives can be used to reduce the use of health care resources, improve compliance with practice guidelines or achieve a general health target. It may be effective to use incentives in combination depending on the target set for a given health care programme.

Cited by 274 publications

References 13 publications

Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians

Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians

A narrative synthesis of illustrative evidence on effects of capitation payment for primary care: lessons for Ghana and other low/middle-income countries

All Things Being Equal: Does it Matter for Equity How You Organize and Pay for Health Care? A Review of the International Evidence

Contact Info

Product

Resources

About