Author : Jafar Sadegh Tabrizi, Mohammad Asghari JafarAbadi, Mostafa Farahbakhsh, Alireza Mahboub Ahari, Shabnam Iezadi*
Background: Despite the growing interest in implementation of pay-for-performance(P4P) programs for improving quality of healthcare, some questions about the effectiveness of P4P remain. At this systematic review two objectives were followed. The first objective was to synthesis the results of pay-for-performance in primary healthcare (PHC) and the second one was to synthesis the design of P4P. Method: Relevant electronic databases including: PubMed, Web of Science, Cochrane Library, ProQ, Scopus and Ovid(Medline/EMBASE) were searched in 20 January 2016. Studies which evaluated the effect of P4P on PHC and have reported full summary of P4P design were included. Primary outcomes were all process and intermediate outcome measures in PHC. Secondary outcomes were client and healthcare providers satisfaction, quality of services, hospital admission and continuity of care. Results: Among 3527 citations 55 articles were included in the analysis. Most of the articles showed positive results especially in disease management, preventative care and quality improvement. A variety of measures in the area of disease management, mental health, Preventative care, family planning, patient experience, substance abuse and management, were identified through review. Payment strategy in most of the articles were achieving absolute level of measure. Conclusion: This review showed that P4P in PHC achieved improvement in most of the fields especially disease management, smoking/alcohol abuse treatment, preventive care and patient experience of care. Various designs of P4P were detected by this review but limited studies have been conducted about the effectiveness of each design. Key words: Pay-For-Performance, Quality Incentive, Payment Strategy, Quality Measure.
Dr. Arend L Mapanawang, Sp.PD, FINASIM, PhD