In Tanzania, the many costs of pay-for-performance leave open to debate whether the strategy is cost-effective

Health Affairs
Josephine BorghiAugust Kuwawenaruwa

Abstract

Pay-for-performance programs in health care are widespread in low- and middle-income countries. However, there are no studies of these programs' costs or cost-effectiveness. We conducted a cost-effectiveness analysis of a pay-for-performance pilot program in Tanzania and modeled costs of its national expansion. We reviewed project accounts and reports, interviewed key stakeholders, and derived outcomes from a controlled before-and-after study. In 2012 US dollars, the financial cost of the pay-for-performance pilot was $1.2 million, and the economic cost was $2.3 million. The incremental cost per additional facility-based birth ranged from $540 to $907 in the pilot and from $94 to $261 for a national program. In a low-income setting, the costs of managing the program and generating and verifying performance data were substantial. Pay-for-performance programs can stimulate the generation and use of health information by health workers and managers for strategic planning purposes, but the time involved could divert attention from service delivery. Pay-for-performance programs may become more cost-effective when integrated into routine systems over time.

References

Jul 7, 1992·Journal of Health Economics·E C Norton
May 13, 2006·Medical Care Research and Review : MCRR·Tammie A NahraJohn R C Wheeler
Aug 16, 2006·Annals of Internal Medicine·Laura A PetersenSupicha Sookanan
Aug 19, 2007·Quality & Safety in Health Care·Sydney E S BrownElbert S Huang
Oct 24, 2007·JAMA : the Journal of the American Medical Association·Mylene LagardeNatasha Palmer
Feb 11, 2009·Archives of Internal Medicine·Hans Joachim SalizeHermann Brenner
Apr 3, 2010·Health Policy and Planning·Sophie WitterVincent De Brouwere
Apr 29, 2010·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Simon WalkerMark Sculpher
Jun 29, 2010·BMC Medical Informatics and Decision Making·Angelo S Nyamtema
Feb 25, 2011·Bulletin of the World Health Organization·Bruno MeessenClaude Sekabaraga
Jun 11, 2011·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Martin EmmertOliver Schöffski
Dec 8, 2011·Health Economics·Alan Maynard
Aug 27, 2013·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Elise Chia-Hui TanMing-Chin Yang

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Citations

Apr 7, 2017·The International Journal of Health Planning and Management·Elisabeth Paul, Dimitri Renmans
Jan 13, 2018·International Journal of Health Policy and Management·Elisabeth PaulKarel Gyselinck
Oct 27, 2018·BMJ Global Health·Y-Ling ChiPeter Smith
May 19, 2019·Health Policy and Planning·Manuela De AllegriAleksandra Torbica
Sep 25, 2019·BMJ : British Medical Journal·Mylène LagardeIrene Papanicolas
Mar 16, 2017·BMC Health Services Research·Matthieu AntonyOlivier Barthes
Oct 18, 2019·Globalization and Health·Victor ChimhutuMwifadhi Mrisho
Apr 4, 2017·Health Policy and Planning·Dimitri RenmansBruno Meessen
Nov 25, 2020·Health Policy and Planning·Susan Cleary
Jan 20, 2021·Journal of Health Organization and Management·Elisabeth PaulValéry Ridde
Aug 31, 2020·Journal of Development Economics·Edward N Okeke, Isa S Abubakar
May 6, 2021·The Cochrane Database of Systematic Reviews·Karin DiaconuSophie Witter
Sep 10, 2018·The Lancet Global Health·Margaret E KrukMuhammad Pate
May 16, 2021·Social Science & Medicine·Eleonora FicheraJosephine Borghi
Sep 1, 2021·Health Economics·Edward N Okeke

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