Economic evaluation of pay-for-performance in health care: a systematic review

Abstract

The results show that evidence on the efficiency of P4P is scarce and inconclusive. P4P efficiency could not be demonstrated. The small number and variability of included studies limit the strength of our conclusions. More research addressing P4P efficiency is needed.

In Tanzania, The Many Costs Of Pay-For-Performance Leave Open To Debate Whether The Strategy Is Cost-Effective

“…4 Despite a growing body of evidence on the effects of pay-for-performance programs, their cost-effectiveness has been much less thoroughly researched. [5][6][7] Only fifteen studies examining the cost of pay-for-performance programs have been published. 8,9 Only two of these cost studies were conducted outside of the United States and Europe.…”

A population-based analysis of incentive payments to primary care physicians for the care of patients with complex disease

“…39 Most research in this area focuses on care for individual diseases, using the delivery of specific services as indicators of quality. 24,[30][31][32][33][34] Evidence of the effect of incentive-based programs on broader outcomes such as access to primary care, continuity of care, 40 hospital admissions [25][26][27][28][29]41,42 and overall resource use 30,34,43 has been inconclusive.…”

Impact of Provider Incentives on Quality and Value of Health Care

“…A second Cochrane review of incentives in primary care found modest improvements for incentivized activities, but it was based on just seven studies that met the strict inclusion criteria (89). Robust evidence on cost-effectiveness is scarcer still: A review by Emmert et al (35) found three full economic evaluations, which taken together suggested that pay-for-performance is an inefficient means of improving quality.…”