基于绩效的融资干预措施对卫生工作者的动力和工作满意度的影响:来自六个国家试点项目的实验证据
Sneha Lamba1, Jed Friedman2, Eeshani Kandpal3
1Sneha Lamba, PhD, Centre for Modern Indian Studies, Chair of Development Economics, University of Göttingen, Waldweg 26, Göttingen 37073, Germany.
基于绩效的融资 (PBF) 没有对卫生工作者的动机或工作满意度产生不利影响. 在某些情况下,PBF对动机和工作满意度产生了积极的影响,挑战了对金融激励措施破坏内在驱动力的担忧.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 卫生健康的人力资源
背景情况:
- 基于绩效的融资 (PBF) 是一种改善医疗服务的策略.
- 人们担心,PBF的经济激励措施可能会降低卫生工作者的内在动机.
- PBF对动机和工作满意度的影响在理论上是模两可的.
研究的目的:
- 实证地评估PBF对卫生工作者动机和工作满意度的影响.
- 调查PBF在各种国家试点计划中的影响.
- 将PBF的影响与其他融资和监管策略进行比较.
主要方法:
- 利用了来自六个国家PBF试点评估的数据.
- 采用随机或准实验性设计,将PBF与直接设施融资,加强监督或通常情况进行比较.
- 进行了基线和终线卫生工作者调查,以衡量动机和工作满意度.
主要成果:
- 尼日利亚和吉尔吉斯共和国的工人总体动机增加,而不是业务正常.
- 在六个国家中有五个国家 (除喀麦隆以外的所有国家) 工作满意度上升.
- 与直接设施融资或加强监管相比,PBF没有表现出系统的激励或降低激励效应,只有一个例外.
结论:
- 有证据表明,PBF不会对卫生工作者的整体动机或工作满意度产生不利影响.
- 在特定的国家背景下,PBF可能对激励和工作满意度产生有益影响.
- 调查结果挑战了这样一种观点,即金融激励措施本质上会降低医疗机构内在动机.
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