Can paying for results help to achieve the Millennium Development Goals? Overview of the effectiveness of results-based financing.

摘要: Objective Results-based financing and pay-for-performance refer to the transfer of money or material goods conditional on taking a measurable action achieving predetermined performance target. is widely advocated for health goals, including Millennium Development Goals. Methods We undertook an overview systematic reviews effectiveness RBF. searched Cochrane Library, EMBASE, MEDLINE (up August 2007). also related articles in PubMed, checked reference lists retrieved articles, contacted key informants. included with methods section that addressed effects any results-based sector targeted at patients, providers, organizations, governments. summarized characteristics findings each review using structured format. Results found 12 met our inclusion criteria. Based these reviews, financial incentives targeting recipients care individual healthcare professionals are effective short run simple distinct, well-defined behavioral goals. There less evidence can sustain long-term changes. Conditional cash transfers poor disadvantaged groups Latin America increasing uptake some preventive services. otherwise very limited low- middle-income countries. have undesirable effects, motivating unintended behaviors, distortions (ignoring important tasks not rewarded incentives), gaming (improving cheating reporting rather than improving performance), widening resource gap between rich poor, dependency incentives. Conclusion almost no cost-effectiveness financing. available likely mechanisms through which work, they more influence discrete behaviors create sustained