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Performance-based financing: the same is different.

Dimitri Renmans1,2, Nathalie Holvoet1, Bart Criel2

  • 1Institute of Development Policy and Management, University of Antwerp, Lange Sint-Annastraat 7, 2000 Antwerp, Belgium.

Health Policy and Planning
|April 4, 2017
PubMed
Summary
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Performance-Based Financing (PBF) is more than just payments for verified outputs. A broader view of PBF as a reform package improves understanding and leads to better-tailored programs and more nuanced debates.

Area of Science:

  • Health policy and systems research
  • Public health interventions
  • Healthcare management

Background:

  • The current research on Performance-Based Financing (PBF) often uses a narrow definition, focusing solely on payments for verified outputs.
  • This limited perspective overlooks the multifaceted nature of PBF as a comprehensive reform package.
  • Such a narrow definition leads to missed opportunities, misunderstandings, and unproductive debates within the research community.

Purpose of the Study:

  • To advocate for a wider definition of Performance-Based Financing (PBF), recognizing it as a reform package with diverse components beyond just financial incentives.
  • To highlight how a narrow definition negatively impacts practitioners, researchers, and policymakers.
  • To propose new research pathways for a more nuanced understanding and implementation of PBF.
Keywords:
Developing countrieshealth care reformhealth financinghealth policyresearch

Related Experiment Videos

Main Methods:

  • Conceptual analysis and argumentation to support a broader definition of PBF.
  • Identification of limitations in current PBF research and evaluation practices.
  • Proposal of three distinct research pathways: describing, understanding, and framing PBF.

Main Results:

  • The study argues that a narrow definition of PBF as solely output-based payments is insufficient and detrimental.
  • Adopting a wider definition, encompassing various reform elements beyond the health worker level, is crucial.
  • Progress in research pathways focusing on description, understanding, and framing PBF is essential for improving knowledge and practice.

Conclusions:

  • A comprehensive understanding of PBF as a reform package is vital for effective implementation and research.
  • The 'same is different' in PBF, emphasizing the need for context-specific approaches.
  • Advancing research through the proposed pathways will enhance PBF programs and foster a more sophisticated debate.