Cochrane · systematic review · CD007899
Paying for performance to improve the delivery of health interventions in low‐ and middle‐income countries
Diaconu, K, Falconer, J, Verbel, A, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
22
current version
GRADE rated
17
No studies
5
Included studies
NR
No studies 5 · 22.7%Ungraded 0 · 0%Very low 0 · 0%Low 17 · 77.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyComparison 1: summary of findings on effects of paying for performance against standard care
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcomes | no estimate extracted | NR | No studies |
Health outcomes | no estimate extracted | NR | Low Downgraded: inconsistency |
Delivery and utilization of health services | no estimate extracted | NR | Low Downgraded: inconsistency |
Quality of care | no estimate extracted | NR | Low Downgraded: inconsistency |
Unintended effects | no estimate extracted | NR | Low Downgraded: inconsistency |
Resource use | no estimate extracted | NR | Low Downgraded: inconsistency |
Secondary outcomes | no estimate extracted | NR | No studies |
Provider motivation, satisfaction, absenteeism and acceptability | no estimate extracted | NR | Low Downgraded: inconsistency |
Patient satisfaction and acceptability | no estimate extracted | NR | Low Downgraded: inconsistency |
Impacts on management or information systems (if not a targeted measure of performance) | no estimate extracted | NR | Low Downgraded: inconsistency |
Equity considerations: evidence of differential impacts on different parts of the population | no estimate extracted | NR | Low Downgraded: inconsistency |
Comparison 2: summary of findings on effects of paying for performance against comparator interventions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Primary outcomes | no estimate extracted | NR | No studies |
Health outcomes | no estimate extracted | NR | Low Downgraded: inconsistency |
Delivery and utilization of health services | no estimate extracted | NR | Low Downgraded: inconsistency |
Quality of care | no estimate extracted | NR | Low Downgraded: inconsistency |
Unintended effects | no estimate extracted | NR | No studies |
Changes in resource use | no estimate extracted | NR | Low Downgraded: inconsistency |
Secondary outcomes | no estimate extracted | NR | No studies |
Provider motivation, satisfaction, absenteeism and acceptability | no estimate extracted | NR | Low Downgraded: inconsistency |
Patient satisfaction and acceptability | no estimate extracted | NR | Low Downgraded: inconsistency |
Impacts on management or information systems (if not a targeted measure of performance) | no estimate extracted | NR | Low Downgraded: inconsistency |
Equity considerations: evidence of differential impacts on different parts of the population | no estimate extracted | NR | Low Downgraded: inconsistency |
Comparison
Population: Providers of healthcare services in low‐ and middle‐income countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Provider performance (quality of care) | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency |
Utilisation of services: antenatal care  | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency |
Utilisation of services: institutional deliveries | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency |
Utilisation of services: preventive care for children, including vaccination | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency |
Utilisation of services: number of outpatients | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency |
Patient outcomes | no estimate extracted | NR | Low Downgraded: risk of bias, inconsistency, indirectness |
Unintended effects | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency, indirectness |
Resource use | no estimate extracted | NR | Very low Downgraded: risk of bias, inconsistency, indirectness |