Author:

• Jorge Otávio Maia Barreto - Barreto, J.O.M. - Piripiri - Universidade Federal do Piauí - Programa de Pós-graduação em Políticas Públicas Campus Universitário Ministro Petrônio Portela Centro de Ciências Humanas e Letras Teresina Piaui 64049-550 Brazil - <jorgeomaia@hotmail.com>
ORCID: https://orcid.org/0000-0002-7648-0472

Thematic Area:

Planejamento e Gestão em Saúde

Abstract:

Pay-for-performance (P4P) has been widely used aiming to improve health outcomes and in Brazil it is the basis of the National Programme for Improving Access and Quality (PMAQ). We revised the literature published between 1998 and January 2013 that evaluatedthe effectiveness of P4P to produce results or patterns of access and quality in health. Were recovered and analyzed 138 studies and included 41 (14 systematic reviews, 07 clinical trials and 20 observational studies). Among the more rigorous studies favorable conclusions to the P4P were less frequent, whereas observational studies were more favorable to positive effects of P4P on the quality and access to health services. Methodological limitations of observational studies may have contributed to these results, but the range of results is more linked to the conceptual and contextual aspects of the use of the P4P schemes reviews, the heterogeneity of models and results of P4P. The P4P can be helpful to promote the achievement of objectives in health systems, especially in the short term and for specific actions requiring less effort of health care providers, but should be used with caution and with rigorous planning model, considering also unwanted or adverse effects.

Keywords:

Pay-for-performance rogramme for Improving Access and Quality (PMAQ).

Content:

Access Issue in Scielo

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