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BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

A reporting framework for describing and a typology for categorizing and analyzing the designs of health care pay for performance schemes

Authors: Yewande Kofoworola Ogundeji, Trevor A. Sheldon, Alan Maynard

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

Pay for Performance (P4P) has increasingly being adopted in different countries as a provider payment mechanism to improve health system performance. Evaluations of pay for performance (P4P) schemes across several countries show significant variation in effectiveness, which may be explained by differences in design. There is however no reliable framework to structure the reporting of the design or a typology to help analyse and interpret results of P4P schemes. This paper reports the development of a reporting framework and a typology of P4P schemes.

Methods

P4P design features were identified from literature and then explored using relevant theories from behavioural and economic science. These design features were then combined with the help of multidimensional tables to produce a reporting framework and a typology which was tested using 74 P4P studies. The inter-rater reliability of the typology was assessed using Fleiss’ Kappa.

Results

A Healthcare Incentive Scheme Reporting Framework (HISReF) was developed consisting of nine design features. This was collapsed into a typology consisting of 4 items/design features. There was good inter-rater reliability on all the four items on the typology (kappa > 0.7).

Conclusion

The HISReF provides an important first step towards establishing a common language in which intervention designers can clearly specify the content of P4P designs. Our typology may be used to aid evidence synthesis and interpretation of results of P4P schemes.
Appendix
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Literature
1.
Eldridge C, Palmer N. Performance-based payment: some reflections on the discourse, evidence and unanswered questions. Health Policy Plan. 2009;24(3):160–6.CrossRefPubMed
2.
3.
4.
5.
Hamilton FL, Greaves F, Majeed A, Millett C. Effectiveness of providing financial incentives to healthcare professionals for smoking cessation activities: systematic review. Tob Control. 2013;22(1):3–8.CrossRefPubMed
6.
7.
Eijkenaar F. Key issues in the design of pay for performance programs. Eur J Health Econ. 2013;14(1):117–31.CrossRefPubMed
8.
9.
McKinney JC. Constructive typology and social theory. New York: Appleton-Century-Crofts; 1966.
10.
Bailey KD. Constructing Monothetic and Polythetic typologies by the heuristic method. Sociol Q. 1973;14(3):291–308.CrossRef
11.
Bailey KD. Typologies and taxonomies an introduction to classification techniques. Sage: Thousand Oaks; 1994.
12.
Elman C. Explanatory typologies in qualitative studies of international politics. Int Organ. 2005;59:293–326.CrossRef
13.
Tiryakian EA. Typologies, vol. 16. New York: Macmillan; 1968.
14.
Eijkenaar F. Pay for performance in health care: an international overview of initiatives. Med Care Res Rev. 2012;69(3):251–76.CrossRefPubMed
15.
Gillam SJ, Siriwardena AN, Steel N. Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review. Ann Fam Med. 2012;10(5):461–8.CrossRefPubMedPubMedCentral
16.
Fleiss JL. Measuring nominal scale agreement among many raters. Psychol Bull. 1971;76:378–82.CrossRef
17.
Ubersax J. Kappa coefficients, a critical appraisal. 2010. Accessed 10 Dec 2013.
18.
Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85(3):257–68.PubMed
19.
Gwet KL. Inter-rater reliability discussion: sample size determination. 2010. In: Accessed 10 December; 2012.
20.
Gross R, Elhaynay A, Friedman N, Buetow S. Pay-for-performance programs in P4P programs Israeli sick funds. J Health Organ Manag. 2008;22(1):23–35.CrossRefPubMed
21.
Tahrani AA, McCarthy M, Godson J, et al. Impact of practice size on delivery of diabetes care before and after the quality and outcomes framework implementation. Br J Gen Pract. 2008;58(553):576–9.CrossRefPubMedPubMedCentral
22.
Chee G, His N, Carlson K, Chankova S, Taylor P. Evaluation of the first five years of GAVI immunization services support funding. GAVI Alliance: Bethesda; 2007.
23.
Trisolini MG. Theoretical Perspectives on Pay for Performance. In: Cromwell J, Trisolini MG, Pope GC, Mitchell JB, Greenwald LM, editors. Pay for Performance in Health Care: Methods and Approaches. North Carolina: Research Triangle Press; 2011. p. 77–98.
24.
Basinga P, Gertler PJ, Binagwaho A, Soucat ALB, Sturdy J, Vermeersch CMJ. Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation. Lancet. 2011;377(9775):1421–8.CrossRefPubMed
25.
Vergeer P, Chansa C. Payment for Performance (P4P) Evaluation 2008 Zambia Country Report for Cordaid. Amsterdam: KIT Development Policy & Practice; 2008.
26.
Ssengooba F, McPake B, Palmer N. Why performance-based contracting failed in Uganda – an “open-box” evaluation of a complex health system intervention. Soc Sci Med. 2012;75(2):377–83.CrossRefPubMed
27.
Ogundeji YK, Jackson C, Sheldon TA, Olubajo O, Ihebuzor N. Pay for performance in Nigeria: the influence of context and implementation on results. Health Policy Plan. 2016;31(8):955–63.
28.
Stewart R. Management of health care. Ashgate/Dartmouth: Aldershot; 1998.
29.
Town R, Wholey DR, Kralewski J, Dowd B. Assessing the influence of incentives on physicians and medical groups. Med Care Res Rev. 2004;61(3 Suppl):80S–118S.CrossRefPubMed
30.
Kidwell RE, Benneth N. Employee propensity to withhold effort: a conceptual model to intersect three avenues of research. Acad Manag Rev. 1993;18(3):429–56.CrossRef
31.
Cooper CL, Dyck B, Frohlich N. Improving the effectiveness of gainsharing: the role of fairness and participation. Adm Sci Q. 1992;37(3):471–90.CrossRef
32.
Shepperd JA. Productivity loss in performance groups: a motivation analysis. Psychol Bull. 1993;113(1):67–81.CrossRef
33.
34.
Pope GC. Overview of pay for performance models and issues. In: Cromwell J, Trisolini MG, Pope GC, Mitchell JB, Greenwald LM, editors. Pay for performance in health care:methods and approaches. North Carolina: Research Traiangle Press; 2011. p. 33–60.
35.
36.
Mehrotra A, Sorbero ME, Damberg CL. Using the lessons of behavioral economics to design more effective pay-for-performance programs. Am J Manag Care. 2010;16(7):497–503.PubMedPubMedCentral
37.
Kinoti S. Effects of performance-based financing on maternal Care in Developing Countries: access, utilization, coverage and health impact. Rapid review of the evidence. Washington, DC: USAID; 2011.
38.
Hargreaves S. Time to right the wrongs: improving basic health care in Nigeria. Lancet. 2002;359(9322):2030–5.CrossRefPubMed
39.
Jeffery S. The benefits of tangible non-monetary incentives 2010. Accessed 12 Aug 2012.
40.
41.
Crifo P, Diaye M. Incentives in agency relationships: to be monetary or non-monetary. 2007. Accessed 8 Aug 2012.
42.
Vroom VH. Work and motivation. New York: McGraw Hill; 1964.
43.
Furnham A, Argyle M. The psychology of money. London: Routledge; 1998.
44.
Hahn J. Pay-for-performance in health care. Washington, DC: Congressional Research Services; 2006.
45.
Mold JW, Hamm RM, McCarthy LH. The law of diminishing returns in clinical medicine: how much risk reduction is enough? J Am Board Fam Med. 2010;23(3):371–5.CrossRefPubMed
46.
Chen TT, Chung KP, Lin IC, Lai MS. The unintended consequence of diabetes mellitus pay-for-performance (P4P) program in Taiwan: are patients with more comorbidities or more severe conditions likely to be excluded from the P4P program? Health Serv Res. 2011;46(1 Pt 1):47–60.CrossRefPubMedPubMedCentral
47.
Jha AK, Joynt KE, Orav EJ, Epstein AM. The long-term effect of premier pay for performance on patient outcomes. N Engl J Med. 2012;366(17):1606–15.CrossRefPubMed
48.
Sutton M, Nikolova S, Boaden R, Lester H, McDonald R, Roland M. Reduced mortality with hospital pay for performance in England. N Eng J Med. 2012;367(19):1821–8.CrossRef
49.
Evans RG. Supplier-induced demand: some empirical evidence and implications. In: Perlman M, editor. The economics of health and medical care. New York: Wiley; 1974.
50.
Desquins B, Holly A, Huguenin J. Physicians’ working practices: target income, altruistic objectives or a maximization problem? Lausanne: Institute of Health Economics and Management (IEMS), University of Lausanne; 2009.
51.
Folland S, Goodman AC, Stano M. Economics of health and health care. New York: Macmillan; 1993.
52.
Rizzo JA, Blumenthal D. Physician income targets: new evidence on an old controversy. Inquiry. 1994;31(4):394–404.PubMed
53.
Rizzo JA, Zeckhauser RJ. Reference Incomes, Loss Aversion, and Physician Behaviour. Rev Econ Stat. 2003;85(4):909–22.CrossRef
54.
Thaler RH. Mental accounting matters. J Behav Decis Mak. 1999;12(3):183–206.CrossRef
55.
Hull CL. The goal-gradient hypothesis and maze learning. Psychol Rev. 1932;39(1):25–43.CrossRef
56.
57.
Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of pay for performance on the quality of primary Care in England. N Engl J Med. 2009;361(4):368–78.CrossRefPubMed
58.
Arrow KJ. The theory of risk aversion. In: Yrjo Jahnssonin Saatio H, editor. Aspects of the Theory of Risk Bearing. Vol essays in the theory of risk bearing. Chicago: Markham Publ. Co.; 1965. p. 90–109.
59.
Oxman AD, Fretheim A. Can paying for results help to achieve the millennium development goals? A critical review of selected evaluations of results-based financing. J Evid Based Med. 2009;2(3):184–95.CrossRefPubMed
60.
Ryan AM, Krinsky S, Kontopantelis E, Doran T. Long-term evidence for the effect of pay-for-performance in primary care on mortality in the UK: a population study. Lancet. 2016;388(10041):268-74.
61.
Thaler R. Mental accounting and consumer choice. Mark Sci. 1985;4(3):199–214.CrossRef
62.
Chung S, Palaniappan L, Wong E, Rubin H, Luft H. Does the frequency of pay-for-performance payment matter?--experience from a randomized trial. Health Serv Res. 2010;45(2):553–64.CrossRefPubMedPubMedCentral
63.
Price C. Time, discounting, and value. Oxford: Blackwell; 1993.
64.
Loewenstein G, Prelec D. Anomalies in intertemporal choice: evidence and an interpretation. Q J Econ. 1992;107(2):573–97.CrossRef
65.
An LC, Bluhm JH, Foldes SS, et al. A randomized trial of a pay-for-performance program targeting clinician referral to a state tobacco quitline. Arch Intern Med. 2008;168(18):1993–9.CrossRefPubMed
66.
Werner RM, Kolstad JT, Stuart EA, Polsky D. The effect of pay-for-performance in hospitals: lessons for quality improvement. Health Aff. 2011;30(4):690–8.CrossRef
67.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.CrossRefPubMed
68.
Altman DG. Practical statistics for medical research. London: Chapman and Hall; 1991.
69.
Fleiss JL. Statistical methods for rates and proportions. New York: Wiley; 1973.
70.
Ogundeji YK, Bland JM, Sheldon TA. The effectiveness of payment for performance in health care: a meta-analysis and exploration of variation in outcomes. Health Policy. 2016;120(10):1141-150.
71.
Van Herck P, De Smedt D, Annemans L, Remmen R, Rosenthal M, Sermeus W. Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Serv Res. 2010;10(1):1–13.CrossRef
72.
Kirschner K, Braspenning J, Akkermans RP, Jacobs JE, Grol R. Assessment of a pay-for-performance program in primary care designed by target users. Fam Pract. 2013;30(2):161–71.CrossRefPubMed
Metadata
Title
A reporting framework for describing and a typology for categorizing and analyzing the designs of health care pay for performance schemes
Authors
Yewande Kofoworola Ogundeji
Trevor A. Sheldon
Alan Maynard
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3479-x

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