Pay for performance at a crossroads: lessons from taking a global perspective
International Journal of Public Sector Management
ISSN: 0951-3558
Article publication date: 31 August 2023
Issue publication date: 5 December 2023
Abstract
Purpose
The use of pay for performance (P4P) as an instrument to incentivise quality improvements in health care is at a crossroads in high-income countries but has remained a commonly used tool in low- and middle-income countries. The authors aimed to take stock of the evidence on effectiveness and design from across income settings to reveal insights for the future design of performance payment across income contexts.
Design/methodology/approach
The authors identified Cochrane literature reviews of the use of P4P in health care in any income setting, tracked the development in the quantity and quality of evidence over time, and compared the incentive design features used across high-income countries compared to low- and middle-income countries.
Findings
The quantity and quality of the evidence base have grown over time but can still be improved. Scheme design varies across income settings, and although some design choices may reflect differences in context, the authors find that incentive designers in both income settings can learn from practices used in the other setting.
Originality/value
The research and literature on P4P in high-, low- and middle-income countries largely operate in silos. By taking stock of the evidence on P4P from across income settings, the authors are able to draw out key insights between these settings, which remain underexplored in the literature.
Keywords
Acknowledgements
The authors acknowledge the presenters and participants at the session “Pay for Performance: Drawing Lessons From Across High, Low and Middle Income Settings” organised by the first author for the Congress of the International Health Economics Association in Basel, Switzerland, July 15, 2019. The authors also acknowledge the presenters and participants in the one-day workshop at the Fifth Global Symposium on Health Systems Research: Advancing Health Systems for All in the Sustainable Development Goals Era in Liverpool, U.K. in October 2018 organised by the PEMBA team.
Funding: All authors except FM were supported by a Health Systems Research Initiative grant [MR/P014429/1] jointly funded by the U.K. Medical Research Council, Wellcome Trust, Economic and Social Research Council, Department for International Development SRK was supported by the NIHR Imperial Patient Safety Translational Research Centre. LA was funded by the UKRI MRC Fellowship MR/S022554/1 RK was supported by a Wellcome Research Fellowship in Humanities and Social Science 219744/Z/19/Z.
Citation
Kristensen, S.R., Anselmi, L., Brown, G.W., Fichera, E., Kovacs, R., Loewenson, R., Singh, N., Midzi, N., Mustapha, F., White, L. and Borghi, J. (2023), "Pay for performance at a crossroads: lessons from taking a global perspective", International Journal of Public Sector Management, Vol. 36 No. 6/7, pp. 592-605. https://doi.org/10.1108/IJPSM-03-2023-0084
Publisher
:Emerald Publishing Limited
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