Performance-Based Incentives for Health: A Way to Improve Tuberculosis Detection and Treatment Completion?

Beith, A; Eichler, Rena; Weil, Diana

doi:10.2139/ssrn.1003247

Cited by 30 publications

(25 citation statements)

References 6 publications

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“…Although Davidson’s model may be a better way to motivate the completion of treatment, it is too complicated to apply in routine busy practice. In our study, the monetary incentives, working as performance rewards [32], were given to migrants in stages when they had to renew their drugs. This was proved to be just as effective as Davidson’s model.…”

Section: Discussionmentioning

confidence: 99%

Providing financial incentives to rural-to-urban tuberculosis migrants in Shanghai: an intervention study

Wei

Zou²,

Yin³

et al. 2012

Infect Dis Poverty

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BackgroundFinancial issues are major barriers for rural-to-urban migrants accessing tuberculosis (TB) care in China. This paper discusses the effectiveness of providing financial incentives to migrant TB patients (with a focus on poor migrants in one district of Shanghai using treatment completion and default rates), the effect of financial incentives in terms of reducing the TB patient cost, and the incremental cost-effectiveness ratio of the intervention.ResultsNinety and ninety-three migrant TB patients were registered in the intervention and control districts respectively. TB treatment completion rates significantly improved by 11% (from 78% to 89%) in the intervention district, compared with only a 3% increase (from 73% to 76%) in the control district (P = 0.03). Default rates significantly decreased by 11% (from 22% to 11%) in the intervention district, compared with 1% (from 24% to 23%) in the control district (P = 0.03). In the intervention district, the financial subsidy (RMB 1,080/US$170) accounted for 13% of the average patient direct cost (RMB 8,416/US$1,332). Each percent increase in treatment completion costs required an additional RMB 6,550 (US$1,301) and each percent reduction in defaults costs required an additional RMB 5,240 (US$825) in the intervention district.ConclusionsOverall, financial incentives proved to be effective in improving treatment completion and reducing default rates among migrant TB patients in Shanghai. The results suggest that financial incentives can be effectively utilized as a strategy to enhance case management among migrant TB patients in large cities in China, and this strategy may be applicable to similar international settings.

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Section: Discussionmentioning

confidence: 99%

Providing financial incentives to rural-to-urban tuberculosis migrants in Shanghai: an intervention study

Wei

Zou²,

Yin³

et al. 2012

Infect Dis Poverty

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“…As evident in the study, the HCWs drew attention to the 'risk' attached to working with TB patients and demanded that incentives be given to those working in the TB units. Although it is not clear why some HCWs feel financial incentives could compensate for the risk of infection, such a stance may not be out of place since there is evidence to suggest that performance-based incentives have a potential to contribute to increasing TB case detection and cure rates [47]. Indeed, with support from the Global Fund, the NTP has started providing 'enablers' package to both TB patients and HCWs in pilot districts in the country.…”

Section: Discussionmentioning

confidence: 99%

Manifestations of tuberculosis stigma within the healthcare system: The case of Sekondi-Takoradi Metropolitan district in Ghana

Dodor¹,

Kelly

2010

Health Policy

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“…RBF targeted at both patients (Table 4) and providers has been used in several countries to improve TB control (12). In Bangladesh, a community‐based approach to DOTS (Directly Observed Treatment Strategy) that included an incentive for community health workers achieved higher detection rates than the rest of the country (90 vs 82%).…”

Section: Resultsmentioning

confidence: 99%

Can paying for results help to achieve the Millennium Development Goals? A critical review of selected evaluations of results‐based financing

Oxman

Fretheim

2009

J Evidence Based Medicine

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When RBF schemes are used, they should be designed carefully, including the level at which they are targeted, the choice of targets and indicators, the type and magnitude of incentives, the proportion of financing that is paid based on results, and the ancillary components of the scheme. For RBF to be effective, it must be part of an appropriate package of interventions, and technical capacity or support must be available. RBF schemes should be monitored for possible unintended effects and evaluated using rigorous study designs.

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Performance-Based Incentives for Health: A Way to Improve Tuberculosis Detection and Treatment Completion?

Cited by 30 publications

References 6 publications

Providing financial incentives to rural-to-urban tuberculosis migrants in Shanghai: an intervention study

Providing financial incentives to rural-to-urban tuberculosis migrants in Shanghai: an intervention study

Manifestations of tuberculosis stigma within the healthcare system: The case of Sekondi-Takoradi Metropolitan district in Ghana

Can paying for results help to achieve the Millennium Development Goals? A critical review of selected evaluations of results‐based financing

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