Pay-for-performance and efficiency in primary oral health care practices in Chile

Background Payment mechanisms for health care providers have been used as a strategy to improve management, health indicators, cost containment, equity and efficiency. Among the mechanisms implemented in the past decade is pay-for-performance (P4P). In Chile, it was incorporated since 2003 in primar...

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Autores principales:	Cornejo-Ovalle,Marco, Brignardello-Petersen,Romina, Pérez,Glòria
Lenguaje:	English
Publicado:	Sociedad de Periodoncia de Chile. Sociedad de Implantología Oral de Chile. Sociedad de Prótesis y Rehabilitación Oral de Chile. 2015
Materias:	Pay for performance Efficiency Child health services Oral health care Chile
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0719-01072015000100009
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spelling	oai:scielo:S0719-010720150001000092015-05-19Pay-for-performance and efficiency in primary oral health care practices in ChileCornejo-Ovalle,MarcoBrignardello-Petersen,RominaPérez,Glòria Pay for performance Efficiency Child health services Oral health care Chile Background Payment mechanisms for health care providers have been used as a strategy to improve management, health indicators, cost containment, equity and efficiency. Among the mechanisms implemented in the past decade is pay-for-performance (P4P). In Chile, it was incorporated since 2003 in primary care in addition to the salary by seniority and training. Objectives To assess the impact of P4P on the efficiency of primary oral health care providers in Chile. Methods We performed a retrospective cohort study to compare the performance of oral healthcare practices belonging to primary health providers measured by the rate of dental discharge in 6 year-old children between years in which P4P was used and years in which P4P was not used, in the 52 municipalities of the Metropolitan Region of Chile. We also explored whether rurality, and the human development index (HDI) had an association with the efficiency of health care teams. We calculated the rate of discharge per 1000 patients, and its adjusted and unadjusted association with the predictors of interest, using a Random-effects Poisson regression. Results We found statistically significant differences in the rate of dental discharges when comparing P4P versus no P4P (822.59/1000 and 662.59/1000, respectively, p < 0.0001) and high versus low HDI (692.23/1000 and 832.85/1000, respectively, p = 0.01). Rurality was not statistically associated with P4P (727.24/1000 in rural and 770.19/1000 in urban municipalities, p = 0.553). Unadjusted and adjusted rate ratios were very similar. Conclusions P4P financial incentives can improve the performance of primary care dental practices, and seem to be useful interventions to improve the performance of oral health care providers.info:eu-repo/semantics/openAccessSociedad de Periodoncia de Chile. Sociedad de Implantología Oral de Chile. Sociedad de Prótesis y Rehabilitación Oral de Chile.Revista clínica de periodoncia, implantología y rehabilitación oral v.8 n.1 20152015-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0719-01072015000100009en10.1016/j.piro.2015.02.011
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Pay for performance Efficiency Child health services Oral health care Chile
spellingShingle	Pay for performance Efficiency Child health services Oral health care Chile Cornejo-Ovalle,Marco Brignardello-Petersen,Romina Pérez,Glòria Pay-for-performance and efficiency in primary oral health care practices in Chile
description	Background Payment mechanisms for health care providers have been used as a strategy to improve management, health indicators, cost containment, equity and efficiency. Among the mechanisms implemented in the past decade is pay-for-performance (P4P). In Chile, it was incorporated since 2003 in primary care in addition to the salary by seniority and training. Objectives To assess the impact of P4P on the efficiency of primary oral health care providers in Chile. Methods We performed a retrospective cohort study to compare the performance of oral healthcare practices belonging to primary health providers measured by the rate of dental discharge in 6 year-old children between years in which P4P was used and years in which P4P was not used, in the 52 municipalities of the Metropolitan Region of Chile. We also explored whether rurality, and the human development index (HDI) had an association with the efficiency of health care teams. We calculated the rate of discharge per 1000 patients, and its adjusted and unadjusted association with the predictors of interest, using a Random-effects Poisson regression. Results We found statistically significant differences in the rate of dental discharges when comparing P4P versus no P4P (822.59/1000 and 662.59/1000, respectively, p < 0.0001) and high versus low HDI (692.23/1000 and 832.85/1000, respectively, p = 0.01). Rurality was not statistically associated with P4P (727.24/1000 in rural and 770.19/1000 in urban municipalities, p = 0.553). Unadjusted and adjusted rate ratios were very similar. Conclusions P4P financial incentives can improve the performance of primary care dental practices, and seem to be useful interventions to improve the performance of oral health care providers.
author	Cornejo-Ovalle,Marco Brignardello-Petersen,Romina Pérez,Glòria
author_facet	Cornejo-Ovalle,Marco Brignardello-Petersen,Romina Pérez,Glòria
author_sort	Cornejo-Ovalle,Marco
title	Pay-for-performance and efficiency in primary oral health care practices in Chile
title_short	Pay-for-performance and efficiency in primary oral health care practices in Chile
title_full	Pay-for-performance and efficiency in primary oral health care practices in Chile
title_fullStr	Pay-for-performance and efficiency in primary oral health care practices in Chile
title_full_unstemmed	Pay-for-performance and efficiency in primary oral health care practices in Chile
title_sort	pay-for-performance and efficiency in primary oral health care practices in chile
publisher	Sociedad de Periodoncia de Chile. Sociedad de Implantología Oral de Chile. Sociedad de Prótesis y Rehabilitación Oral de Chile.
publishDate	2015
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0719-01072015000100009
work_keys_str_mv	AT cornejoovallemarco payforperformanceandefficiencyinprimaryoralhealthcarepracticesinchile AT brignardellopetersenromina payforperformanceandefficiencyinprimaryoralhealthcarepracticesinchile AT perezgloria payforperformanceandefficiencyinprimaryoralhealthcarepracticesinchile
_version_	1714206687040110592

Pay-for-performance and efficiency in primary oral health care practices in Chile

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