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
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , |
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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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 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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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 |
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https://www.arca.fiocruz.br/handle/icict/54472 |
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eng |
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eng |
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Springer Nature |
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Springer Nature |
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