Pay-for-performance for primary health care in Brazil: A comparison with England's Quality Outcomes Framework and lessons for the future

Gurgel, Garibaldi Dantas; Kristensen, Søren Rud; Silva, Everton Nunes da; Gomes, Luciano Bezerra; Barreto, Jorge Otávio Maia; Kovacs, Roxanne; Sampaio, Juliana Vieira; Bezerra, Adriana Falangola Benjamin; Silva, Keila Silene de Brito e; Shimizu, Helena Eri; Sousa, Allan Nuno Alves de; Fardousi, Nasser; Borghi, Josephine; Powell-Jackson, Timothy

doi:10.1016/j.healthpol.2022.11.004

Cited by 2 publications

(3 citation statements)

References 37 publications

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“…As equipes sentem necessidade de que, na avaliação, sejam consideradas as particularidades de cada território, reconhecendo suas especificidades e limitações e possibilitando o planejamento de estratégias singulares. Estudo de Gurgel et al 14 reafirma a necessidade de o PMAQ considerar em seus indicadores de avaliação aspectos do contexto singular do campo a ser avaliado.…”

Section: Narrativa 3: Críticas à Bonificação Pontual E à Precarização...unclassified

“…Interface (Botucatu) 2024; 28: e230352 https://doi.org/10.1590/Interface.230352 Uma característica importante do PMAQ estava relacionada ao fornecimento de um incentivo financeiro, que não era fornecido diretamente à equipe assistencial de Saúde, mas sim à gestão municipal de Saúde. Esta tinha a autonomia para decidir a forma de aplicação do recurso, definindo se ele se daria e como seria feito o pagamento de bônus às equipes da ABS 13,14 .…”

Section: Introductionunclassified

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Reflexos do pagamento por desempenho na atuação do(a)s profissionais da Atenção Primária à Saúde, Paraíba, Brasil

Bezerra,

Gomes

et al. 2024

Interface (Botucatu)

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O estudo buscou compreender a influência da estratégia do Pay for Performance (P4P), por meio do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ-AB), na atuação do(a)s trabalhadore(a)s. Trata-se de um estudo de caso qualitativo realizado com o(a)s trabalhadore(a)s das Estratégias de Saúde da Família. A análise foi realizada mediante a técnica de construção de narrativas. Constatou-se que o P4P contribuiu para qualificação do processo de trabalho, ao mesmo tempo que estimulou competição e conflito entre as equipes, aflorando sentimentos de culpa e injustiça e, devido à precarização do trabalho, o estímulo financeiro se descaracteriza, tornando-se complemento salarial. Problemas macroestruturais afetam as condições de trabalho e a motivação do(a)s trabalhadore(a)s, de modo que modelos de incentivo financeiro, isoladamente, não são suficientes para reverter tal cenário.

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Section: Narrativa 3: Críticas à Bonificação Pontual E à Precarização...unclassified

Section: Introductionunclassified

Reflexos do pagamento por desempenho na atuação do(a)s profissionais da Atenção Primária à Saúde, Paraíba, Brasil

Bezerra,

Gomes

et al. 2024

Interface (Botucatu)

Self Cite

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“…For example, Brazil funds its PHC through a mixed nancing model that takes into account a capitation method weighted by equity criteria, payment-for-performance of the Family Health teams, and incentives for strategic and priority actions. 11 Thailand's nancing for UHC is predominantly non-contributory, nanced by general government taxation. This mode of nancing is based on several assumptions.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Implementation of the National Primary Health Care Development Agency (NPHCDA) Gateway for the Basic Healthcare Provision Fund (BHCPF) Across Six Northern States in Nigeria

Igbokwe,

Ibrahim,

Aina

et al. 2024

Preprint

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Background: This evaluation research utilized both qualitative and quantitative methods to assess the implementation of the National Primary Health Care Development Agency (NPHCDA) gateway of the Basic Health Care Provision Fund (BHCPF) across six states in Northern Nigeria: Bauchi, Borno, Kaduna, Kano, Sokoto, and Yobe. Methods: This was a mixed-method research that utilized longitudinal surveys and Key informant interviews to gather information about the implementation status of the BHCPF-NPHCDA gateway. Checklists were developed based on the BHCPF’s national guidelines to gather quantitative data, while simple open-ended questionnaires were used to collect qualitative data from the state BHCPF Program Implementation Unit (PIU) focal persons as key informants. Results: The result revealed that the NPHCDA had accredited these six states to use one Primary Health Care (PHC) facility in each political ward to implement the BHCPF. Factors that contributed to the success achieved in some states included the early completion of contingent start-up activities, well-established coordination structures, strong support from partners, and availability of established financial management systems. However, the delays in the submission of quarterly business plans by the BHCPF facilities affected timely approval and fund disbursement. Other challenges included staff capacity gaps, inadequate human resources, and poor management and supervision from the state health agency teams. Conclusion: There was suboptimal implementation of the BHCPF in at least one thematic area across all states. Therefore, actions such as government commitment for improved coordination, continuous capacity building, effective monitoring and evaluation, and targeted supportive supervision using innovative approaches should be undertaken to improve the program’s implementation. In a broader setting, the insights from BHCPF implementation are valuable for LMICs, offering guidance on overcoming implementation challenges associated with PHC financing. This research provides a resource for enhancing healthcare financing strategies in similar contexts.

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Pay-for-performance for primary health care in Brazil: A comparison with England's Quality Outcomes Framework and lessons for the future

Cited by 2 publications

References 37 publications

Reflexos do pagamento por desempenho na atuação do(a)s profissionais da Atenção Primária à Saúde, Paraíba, Brasil

Reflexos do pagamento por desempenho na atuação do(a)s profissionais da Atenção Primária à Saúde, Paraíba, Brasil

Evaluating the Implementation of the National Primary Health Care Development Agency (NPHCDA) Gateway for the Basic Healthcare Provision Fund (BHCPF) Across Six Northern States in Nigeria

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