Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018

Detalhes bibliográficos
Autor(a) principal: Russo, Letícia Xander
Data de Publicação: 2021
Outros Autores: Powell-Jackson, Timothy, Barreto, Jorge Otavio Maia, Borghi, Josephine, Kovacs, Roxanne, Gurgel Junior, Garibaldi Dantas, Gomes, Luciano Bezerra, Sampaio, Juliana, Shimizu, Helena Eri, Sousa, Allan Nuno Alves de, Bezerra, Adriana Falangola Benjamin, Stein, Airton Tetelbom, Silva, Everton Nunes da
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/54472
Resumo: This research was funded by the Medical Research Council, Newton Fund and the Brazilian National Council for the States Funding Agencies (CONFAP) under the UK- Brazil Joint Health Systems Research Call (grant MR/R022828/1). Funding from CONFAP came from Fundação de Amparo à Pesquisa do Distrito Federal (FAPDF), Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE) and Fundação de Apoio à Pesquisa do Estado da Paraíba (FAPESQ).
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spelling Russo, Letícia XanderPowell-Jackson, TimothyBarreto, Jorge Otavio MaiaBorghi, JosephineKovacs, RoxanneGurgel Junior, Garibaldi DantasGomes, Luciano BezerraSampaio, JulianaShimizu, Helena EriSousa, Allan Nuno Alves deBezerra, Adriana Falangola BenjaminStein, Airton TetelbomSilva, Everton Nunes da2022-08-05T14:00:58Z2022-08-05T14:00:58Z2021RUSSO, Letícia Xander et al. Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018. BMJ Global Health, [s. l.], v. 6, n. 7, p.1-9, 2021.2059-7908https://www.arca.fiocruz.br/handle/icict/5447210.1136/bmjgh-2021-005429This research was funded by the Medical Research Council, Newton Fund and the Brazilian National Council for the States Funding Agencies (CONFAP) under the UK- Brazil Joint Health Systems Research Call (grant MR/R022828/1). Funding from CONFAP came from Fundação de Amparo à Pesquisa do Distrito Federal (FAPDF), Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE) and Fundação de Apoio à Pesquisa do Estado da Paraíba (FAPESQ).Federal University of Grande Dourados. Department of Economics. Dourados, MS, Brazil.London School of Hygiene and Tropical Medicine. Department of Global Health and Development. London, United Kingdom.Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.London School of Hygiene and Tropical Medicine. Department of Global Health and Development. London, United Kingdom.London School of Hygiene and Tropical Medicine. Department of Global Health and Development. London, United Kingdom.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, BrasilFederal University of Paraiba. Department of Health Promotion. João Pessoa, PB, Brazil.Federal University of Paraiba. Department of Health Promotion. João Pessoa, PB, Brazil.University of Brasilia. Department of Collective Health. Brasília, DF, Brazil.Ministry of Health. Brasilia, DF, Brazil.Federal University of Pernambuco. Department of Social Medicine. Recife, PE, Brazil.Federal University of Health Sciences of Porto Alegre. Department of Public Health. Porto Alegre, RS, Brazil.University of Brasilia. Faculty of Ceilandia. Brasilia, DF, Brazil.Background Evidence on the effect of pay-for- performance (P4P) schemes on provider performance is mixed in low-income and middle-income countries. Brazil introduced its first national-level P4P scheme in 2011 (PMAQ-Brazilian National Programme for Improving Primary Care Access and Quality). PMAQ is likely one of the largest P4P schemes in the world. We estimate the association between PMAQ and hospitalisations for ambulatory care sensitive conditions (ACSCs) based on a panel of 5564 municipalities. Methods We conducted a fixed effect panel data analysis over the period of 2009–2018, controlling for coverage of primary healthcare, hospital beds per 10 000 population, education, real gross domestic product per capita and population density. The outcome is the hospitalisation rate for ACSCs among people aged 64 years and under per 10 000 population. Our exposure variable is defined as the percentage of family health teams participating in PMAQ, which captures the roll-out of PMAQ over time. We also provided several sensitivity analyses, by using alternative measures of the exposure and outcome variables, and a placebo test using transport accident hospitalisations instead of ACSCs. Results The results show a negative and statistically significant association between the rollout of PMAQ and ACSC rates for all age groups. An increase in PMAQ participating of one percentage point decreased the hospitalisation rate for ACSC by 0.0356 (SE 0.0123, p=0.004) per 10 000 population (aged 0–64 years). This corresponds to a reduction of approximately 60 829 hospitalisations in 2018. The impact is stronger for children under 5 years (−0.0940, SE 0.0375, p=0.012), representing a reduction of around 11 936 hospitalisations. Our placebo test shows that the association of PMAQ on the hospitalisation rate for transport accidents is not statistically significant, as expected. Conclusion We find that PMAQ was associatedengSpringer NatureHealth Care Economics and OrganizationsHealth PolicyHealth economicsHealth policyPublic healthEconomia e Organizações de SaúdePolíticas PúblicasPolítica de SaúdeSaúde PúblicaPay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.pt_BR.fl_str_mv Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
title Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
spellingShingle Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
Russo, Letícia Xander
Health Care Economics and Organizations
Health Policy
Health economics
Health policy
Public health
Economia e Organizações de Saúde
Políticas Públicas
Política de Saúde
Saúde Pública
title_short Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
title_full Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
title_fullStr Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
title_full_unstemmed Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
title_sort Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018
author Russo, Letícia Xander
author_facet Russo, Letícia Xander
Powell-Jackson, Timothy
Barreto, Jorge Otavio Maia
Borghi, Josephine
Kovacs, Roxanne
Gurgel Junior, Garibaldi Dantas
Gomes, Luciano Bezerra
Sampaio, Juliana
Shimizu, Helena Eri
Sousa, Allan Nuno Alves de
Bezerra, Adriana Falangola Benjamin
Stein, Airton Tetelbom
Silva, Everton Nunes da
author_role author
author2 Powell-Jackson, Timothy
Barreto, Jorge Otavio Maia
Borghi, Josephine
Kovacs, Roxanne
Gurgel Junior, Garibaldi Dantas
Gomes, Luciano Bezerra
Sampaio, Juliana
Shimizu, Helena Eri
Sousa, Allan Nuno Alves de
Bezerra, Adriana Falangola Benjamin
Stein, Airton Tetelbom
Silva, Everton Nunes da
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Russo, Letícia Xander
Powell-Jackson, Timothy
Barreto, Jorge Otavio Maia
Borghi, Josephine
Kovacs, Roxanne
Gurgel Junior, Garibaldi Dantas
Gomes, Luciano Bezerra
Sampaio, Juliana
Shimizu, Helena Eri
Sousa, Allan Nuno Alves de
Bezerra, Adriana Falangola Benjamin
Stein, Airton Tetelbom
Silva, Everton Nunes da
dc.subject.mesh.pt_BR.fl_str_mv Health Care Economics and Organizations
Health Policy
topic Health Care Economics and Organizations
Health Policy
Health economics
Health policy
Public health
Economia e Organizações de Saúde
Políticas Públicas
Política de Saúde
Saúde Pública
dc.subject.en.pt_BR.fl_str_mv Health economics
Health policy
Public health
dc.subject.decs.pt_BR.fl_str_mv Economia e Organizações de Saúde
Políticas Públicas
Política de Saúde
Saúde Pública
description This research was funded by the Medical Research Council, Newton Fund and the Brazilian National Council for the States Funding Agencies (CONFAP) under the UK- Brazil Joint Health Systems Research Call (grant MR/R022828/1). Funding from CONFAP came from Fundação de Amparo à Pesquisa do Distrito Federal (FAPDF), Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco (FACEPE) and Fundação de Apoio à Pesquisa do Estado da Paraíba (FAPESQ).
publishDate 2021
dc.date.issued.fl_str_mv 2021
dc.date.accessioned.fl_str_mv 2022-08-05T14:00:58Z
dc.date.available.fl_str_mv 2022-08-05T14:00:58Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv RUSSO, Letícia Xander et al. Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018. BMJ Global Health, [s. l.], v. 6, n. 7, p.1-9, 2021.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/54472
dc.identifier.issn.pt_BR.fl_str_mv 2059-7908
dc.identifier.doi.none.fl_str_mv 10.1136/bmjgh-2021-005429
identifier_str_mv RUSSO, Letícia Xander et al. Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018. BMJ Global Health, [s. l.], v. 6, n. 7, p.1-9, 2021.
2059-7908
10.1136/bmjgh-2021-005429
url https://www.arca.fiocruz.br/handle/icict/54472
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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collection Repositório Institucional da FIOCRUZ (ARCA)
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https://www.arca.fiocruz.br/bitstream/icict/54472/2/ve_Leticia_Russo_etal_FiocruzBSB_2021.pdf
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