Using Performance Incentives to Improve Health Outcomes

Gertler, Paul; Vermeersch, Christel

Using Performance Incentives to Improve Health Outcomes

Autores

Gertler, Paul

Vermeersch, Christel

Editor

World Bank, Washington, DC

Descripción

This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0-11 months and on the height-for-age of children 24-49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill.

Palabras clave

ACUTE MYOCARDIAL INFARCTION, AGE GROUPS, ALCOHOL, ALCOHOL USE, ANEMIA, BABY, BABY CARE, BLEEDING, BREAST MILK, BREAST-FEEDING, BULLETIN, CAPACITY BUILDING, CASE MANAGEMENT, CHILD CARE, CHILD GROWTH MONITORING, CHILD HEALTH, CHILD HEALTH CARE, CHILD HEALTH SERVICES, CHILD MEDICAL CARE, CHILD MORTALITY, CHILD MORTALITY RATES, CHILD NUTRITION, CHRONIC MALNUTRITION, CLEANLINESS, CLINICAL PRACTICE, CLINICAL SERVICES, CLINICS, COMMUNITY DEVELOPMENT, COMMUNITY HEALTH, COMMUNITY HEALTH WORKERS, CONTRACEPTIVE PREVALENCE, CONTRACEPTIVE USAGE, CONTRACEPTIVE USERS, CONTRACEPTIVES, DEATHS, DEVELOPING COUNTRIES, DEVELOPMENT POLICY, DIABETES, DIAGNOSIS, DIARRHEA, DIET, DISSEMINATION, DISTRICT HOSPITAL, DOCTORS, DRUGS, EARLY PREGNANCY, EMERGENCIES, ETHICAL STANDARDS, EXPENDITURES, FAMILIES, FAMILY PLANNING, FETUS, FEVER, FINANCIAL MANAGEMENT, GENOCIDE, GLOBAL HEALTH, HEALTH CARE, HEALTH CARE INSTITUTIONS, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE SERVICES, HEALTH CARE SYSTEM, HEALTH CARE UTILIZATION, HEALTH CENTERS, HEALTH CLINICS, HEALTH CONDITIONS, HEALTH ECONOMICS, HEALTH FACILITIES, HEALTH FACILITY, HEALTH INSURANCE, HEALTH INTERVENTIONS, HEALTH OUTCOMES, HEALTH PROBLEMS, HEALTH PROVIDERS, HEALTH SECTOR, HEALTH SERVICES, HEALTH SERVICES RESEARCH, HEALTH SYSTEM, HEALTH TARGETS, HEALTH WORKERS, HEALTH-CARE PROVIDERS, HIGH BLOOD PRESSURE, HIGH-RISK, HIV, HOSPITAL, HOSPITALS, HOUSEHOLD ASSETS, HOUSEHOLD SURVEYS, HUMAN DEVELOPMENT, ILLNESS, ILLNESSES, IMMUNIZATION, IMMUNIZATIONS, INCOME, INDIVIDUAL CHARACTERISTICS, INFANT, INFANT MORTALITY, INFANTS, INFECTION, INFORMATION CAMPAIGNS, INTERVENTION, JOURNAL OF MEDICINE, LAB TESTS, LABOR SUPPLY, LEVELS OF KNOWLEDGE, LIVE BIRTHS, LOW BIRTH WEIGHT, LOW-INCOME COUNTRIES, MALARIA, MALARIA PROPHYLAXIS, MALNOURISHED CHILDREN, MATERNAL AND CHILD HEALTH, MATERNAL HEALTH, MATERNAL HEALTH CARE, MATERNAL HEIGHT, MATERNAL MORTALITY, MEDICAL CARE, MEDICAL DOCTORS, MEDICAL EQUIPMENT, MEDICAL PERSONNEL, MEDICAL PRACTICE, MEDICAL SERVICES, MEDICAL SUPPLIES, MEDICAL TECHNICIANS, MICRONUTRIENTS, MIDWIVES, MILLENNIUM DEVELOPMENT GOAL, MILLENNIUM DEVELOPMENT GOALS, MINISTRY OF HEALTH, MISCARRIAGES, MODERN CONTRACEPTION, MORTALITY, MOSQUITO NETS, MOTHER, MYOCARDIAL INFARCTION, NATIONAL HEALTH, NAUSEA, NUMBER OF CHILDREN, NUMBER OF WOMEN, NURSES, NUTRITION, NUTRITIONAL ADVICE, OBSTETRIC SERVICES, OLDER CHILDREN, OWNERSHIP OF LAND, PAP SMEAR, PATIENT, PATIENTS, PHARMACY, PHYSICAL EXAMINATIONS, PHYSICIAN, PHYSICIANS, POLICY DISCUSSIONS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POSTNATAL CARE, PRACTITIONERS, PREGNANCY, PREGNANCY STATUS, PREGNANT WOMAN, PREGNANT WOMEN, PRENATAL CARE, PRIMARY CARE, PRIMARY EDUCATION, PRIMARY HEALTH-CARE, PRIMARY SCHOOL, PROBABILITY, PROGRESS, PROPHYLAXIS, PROVIDER INCENTIVES, PROVIDER PAYMENT, QUALITY CARE, QUALITY CONTROL, QUALITY IMPROVEMENT, QUALITY OF CARE, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, QUALITY SERVICES, RESOURCE CONSTRAINTS, RISK PREGNANCIES, RURAL AREAS, SERVICE DELIVERY, SEX, SEXUALLY TRANSMITTED INFECTIONS, SMEAR TEST, SOCIAL AFFAIRS, SOCIAL NORMS, SOCIAL RESEARCH, SOCIOECONOMIC STATUS, STAGES OF LIFE, SYMPTOM, SYMPTOMS, TETANUS, TOBACCO, TOBACCO USE, TREATMENT, TROPICAL MEDICINE, TUBERCULOSIS, URINE SAMPLE, VACCINATION, VACCINE, VACCINES, VOMITING, WEIGHT GAIN, WEIGHT LOSS, WOMAN, WORKERS, WORLD HEALTH ORGANIZATION