Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation

In order to advance our understanding of why Results Based Financing (RBF) works or not, it is crucial that evaluations not only measure the impact of such an arrangement on final outcomes (population health), but also assess the changes in variables in the causal chain between intervention and f...

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Main Authors:	Lemiere, Christophe, Torsvik, Gaute, Maestad, Ottar, Herbst, Christopher H., Leonard, Kenneth L.
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2015
Subjects:	CHILD HEALTH HEALTH SERVICE PROVIDER EMPLOYMENT CLINICAL GUIDELINES HEALTH SERVICE DELIVERY MOTIVATION PERSONALITY PRODUCTION PHYSICIAN VACCINATION IMPACT ON HEALTH OUTCOMES PROVISION OF HEALTH CARE FINANCING ANTENATAL CARE DEATHS INCOME QUALITY OF HEALTH CARE PSYCHOLOGY HEALTH CARE UTILIZATION FEE FOR SERVICE PUBLIC SECTOR DOCTORS MARGINAL COST ORGANIZATIONAL PSYCHOLOGY HEALTH ECONOMICS MORBIDITY ECONOMIC REVIEW COST-EFFECTIVENESS INFORMATION MONITORING HEALTH CARE HEALTH CARE WORKERS EFFECTS HEALTH CARE FACILITIES INCENTIVES HEALTH EQUILIBRIUM INFORMAL PAYMENTS HEALTH WORKERS CITIES HEALTH SERVICE UTILIZATION HEALTH FACILITIES HEALTH WORKERS’ PERFORMANCE QUALITY OF HEALTH HEALTH SECTOR KNOWLEDGE CHOICE ECONOMIC PERSPECTIVES COSTS PATIENTS PATIENT INTERVENTION LOW-INCOME COUNTRIES PROBABILITY PRODUCTIVITY IMPACT EVALUATIONS NURSES HEALTH CARE SERVICES OBSERVATION ORGANIZATIONS ANXIETY HEALTH CARE QUALITY HEALTH WORKFORCE STANDARDS HEALTH ORGANIZATION WORK ENVIRONMENT OUTPATIENT SERVICES INTERVIEW MORTALITY FINANCIAL INCENTIVE SOCIAL SUPPORT EFFICIENCY ADMINISTRATIVE COSTS UNEMPLOYMENT HEALTH CARE SECTOR EXTERNALITY PREGNANCY COMPLICATIONS HEALTH SERVICE PROVISION WORKERS WAGES INCENTIVE SCHEMES CROWDING HEALTH-CARE CLINICAL QUALITY VALUE CARE DEMAND HEALTH OUTCOMES HEALTH-CARE PROVIDERS MARGINAL COSTS FAMILY PLANNING STRESS INCOME COUNTRIES BLOOD DONATIONS INTRINSIC MOTIVATION PRIVATE SECTOR MEASUREMENT OPPORTUNITY COSTS NUTRITION ECONOMIC THEORY ECONOMICS PRIMARY HEALTH CARE INTERNET MANAGEMENT HEALTH CARE CENTERS HEALTH SYSTEM WEIGHT PHYSICIANS LOW INCOME THEORY CHILDREN EVALUATION RISK HUMAN RESOURCES ILLNESS SUPPLY COOPERATION REHABILITATION POPULATION STRATEGY NEWBORN HEALTH FEES CHILD HEALTH SERVICES MEDICINES HOSPITALS OUTCOMES BIRTH ATTENDANT HEALTH SERVICE HEALTH SERVICES IMPLEMENTATION PREGNANCY PROVIDER PAYMENT FINANCIAL INCENTIVES ABSENTEEISM HEALTH WORKERS PERFORMANCE HUMAN DEVELOPMENT
Online Access:	http://documents.worldbank.org/curated/en/2015/07/24819487/evaluating-impact-results-based-financing-health-worker-performance-theory-tools-variables-inform-impact-evaluation http://hdl.handle.net/10986/22375

id	okr-10986-22375
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spelling	okr-10986-223752021-04-23T14:04:08Z Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation Lemiere, Christophe Torsvik, Gaute Maestad, Ottar Herbst, Christopher H. Leonard, Kenneth L. CHILD HEALTH HEALTH SERVICE PROVIDER EMPLOYMENT CLINICAL GUIDELINES HEALTH SERVICE DELIVERY MOTIVATION PERSONALITY PRODUCTION PHYSICIAN VACCINATION IMPACT ON HEALTH OUTCOMES PROVISION OF HEALTH CARE FINANCING ANTENATAL CARE DEATHS INCOME QUALITY OF HEALTH CARE PSYCHOLOGY HEALTH CARE UTILIZATION FEE FOR SERVICE PUBLIC SECTOR DOCTORS MARGINAL COST ORGANIZATIONAL PSYCHOLOGY HEALTH ECONOMICS MORBIDITY ECONOMIC REVIEW COST-EFFECTIVENESS INFORMATION MONITORING HEALTH CARE HEALTH CARE WORKERS EFFECTS HEALTH CARE FACILITIES INCENTIVES HEALTH EQUILIBRIUM INFORMAL PAYMENTS HEALTH WORKERS CITIES HEALTH SERVICE UTILIZATION HEALTH FACILITIES HEALTH WORKERS’ PERFORMANCE QUALITY OF HEALTH HEALTH SECTOR KNOWLEDGE CHOICE ECONOMIC PERSPECTIVES COSTS PATIENTS PATIENT INTERVENTION LOW-INCOME COUNTRIES PROBABILITY PRODUCTIVITY IMPACT EVALUATIONS NURSES HEALTH CARE SERVICES OBSERVATION ORGANIZATIONS ANXIETY HEALTH CARE QUALITY HEALTH WORKFORCE STANDARDS HEALTH ORGANIZATION WORK ENVIRONMENT OUTPATIENT SERVICES INTERVIEW MORTALITY FINANCIAL INCENTIVE SOCIAL SUPPORT EFFICIENCY ADMINISTRATIVE COSTS UNEMPLOYMENT HEALTH CARE SECTOR EXTERNALITY PREGNANCY COMPLICATIONS HEALTH SERVICE PROVISION WORKERS WAGES INCENTIVE SCHEMES CROWDING HEALTH-CARE CLINICAL QUALITY VALUE CARE DEMAND HEALTH OUTCOMES HEALTH-CARE PROVIDERS MARGINAL COSTS FAMILY PLANNING STRESS INCOME COUNTRIES BLOOD DONATIONS INTRINSIC MOTIVATION PRIVATE SECTOR MEASUREMENT OPPORTUNITY COSTS NUTRITION ECONOMIC THEORY ECONOMICS PRIMARY HEALTH CARE INTERNET MANAGEMENT HEALTH CARE CENTERS HEALTH SYSTEM WEIGHT PHYSICIANS LOW INCOME THEORY CHILDREN EVALUATION RISK HUMAN RESOURCES ILLNESS SUPPLY COOPERATION REHABILITATION POPULATION STRATEGY NEWBORN HEALTH FEES CHILD HEALTH SERVICES MEDICINES HOSPITALS OUTCOMES BIRTH ATTENDANT HEALTH SERVICE HEALTH SERVICES IMPLEMENTATION PREGNANCY PROVIDER PAYMENT FINANCIAL INCENTIVES ABSENTEEISM HEALTH WORKERS PERFORMANCE HUMAN DEVELOPMENT In order to advance our understanding of why Results Based Financing (RBF) works or not, it is crucial that evaluations not only measure the impact of such an arrangement on final outcomes (population health), but also assess the changes in variables in the causal chain between intervention and final outcomes. Health worker performance is a key variable in this chain; it is only by changing health workers’ behaviors—their performance—that RBF can influence health outcomes. Careful assessment of impacts on health worker performance is therefore a natural and important element of any RBF impact evaluations. This paper discusses various approaches to evaluating the impact of RBF on health worker performance. The first part is a discussion of possible ways in which RBF may affect health worker behavior, based on economic theory and empirical evidence. The second part is a more practical discussion of how health worker performance and other relevant variables can be measured and how impacts can be estimated. This is followed by some practical steps that can be taken to ensure that the evaluation leads to actions that can be implemented; a brief conclusion completes the paper. 2015-07-31T20:22:43Z 2015-07-31T20:22:43Z 2013-01 Working Paper http://documents.worldbank.org/curated/en/2015/07/24819487/evaluating-impact-results-based-financing-health-worker-performance-theory-tools-variables-inform-impact-evaluation http://hdl.handle.net/10986/22375 English en_US HNP discussion paper series; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Working Paper
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	CHILD HEALTH HEALTH SERVICE PROVIDER EMPLOYMENT CLINICAL GUIDELINES HEALTH SERVICE DELIVERY MOTIVATION PERSONALITY PRODUCTION PHYSICIAN VACCINATION IMPACT ON HEALTH OUTCOMES PROVISION OF HEALTH CARE FINANCING ANTENATAL CARE DEATHS INCOME QUALITY OF HEALTH CARE PSYCHOLOGY HEALTH CARE UTILIZATION FEE FOR SERVICE PUBLIC SECTOR DOCTORS MARGINAL COST ORGANIZATIONAL PSYCHOLOGY HEALTH ECONOMICS MORBIDITY ECONOMIC REVIEW COST-EFFECTIVENESS INFORMATION MONITORING HEALTH CARE HEALTH CARE WORKERS EFFECTS HEALTH CARE FACILITIES INCENTIVES HEALTH EQUILIBRIUM INFORMAL PAYMENTS HEALTH WORKERS CITIES HEALTH SERVICE UTILIZATION HEALTH FACILITIES HEALTH WORKERS’ PERFORMANCE QUALITY OF HEALTH HEALTH SECTOR KNOWLEDGE CHOICE ECONOMIC PERSPECTIVES COSTS PATIENTS PATIENT INTERVENTION LOW-INCOME COUNTRIES PROBABILITY PRODUCTIVITY IMPACT EVALUATIONS NURSES HEALTH CARE SERVICES OBSERVATION ORGANIZATIONS ANXIETY HEALTH CARE QUALITY HEALTH WORKFORCE STANDARDS HEALTH ORGANIZATION WORK ENVIRONMENT OUTPATIENT SERVICES INTERVIEW MORTALITY FINANCIAL INCENTIVE SOCIAL SUPPORT EFFICIENCY ADMINISTRATIVE COSTS UNEMPLOYMENT HEALTH CARE SECTOR EXTERNALITY PREGNANCY COMPLICATIONS HEALTH SERVICE PROVISION WORKERS WAGES INCENTIVE SCHEMES CROWDING HEALTH-CARE CLINICAL QUALITY VALUE CARE DEMAND HEALTH OUTCOMES HEALTH-CARE PROVIDERS MARGINAL COSTS FAMILY PLANNING STRESS INCOME COUNTRIES BLOOD DONATIONS INTRINSIC MOTIVATION PRIVATE SECTOR MEASUREMENT OPPORTUNITY COSTS NUTRITION ECONOMIC THEORY ECONOMICS PRIMARY HEALTH CARE INTERNET MANAGEMENT HEALTH CARE CENTERS HEALTH SYSTEM WEIGHT PHYSICIANS LOW INCOME THEORY CHILDREN EVALUATION RISK HUMAN RESOURCES ILLNESS SUPPLY COOPERATION REHABILITATION POPULATION STRATEGY NEWBORN HEALTH FEES CHILD HEALTH SERVICES MEDICINES HOSPITALS OUTCOMES BIRTH ATTENDANT HEALTH SERVICE HEALTH SERVICES IMPLEMENTATION PREGNANCY PROVIDER PAYMENT FINANCIAL INCENTIVES ABSENTEEISM HEALTH WORKERS PERFORMANCE HUMAN DEVELOPMENT
spellingShingle	CHILD HEALTH HEALTH SERVICE PROVIDER EMPLOYMENT CLINICAL GUIDELINES HEALTH SERVICE DELIVERY MOTIVATION PERSONALITY PRODUCTION PHYSICIAN VACCINATION IMPACT ON HEALTH OUTCOMES PROVISION OF HEALTH CARE FINANCING ANTENATAL CARE DEATHS INCOME QUALITY OF HEALTH CARE PSYCHOLOGY HEALTH CARE UTILIZATION FEE FOR SERVICE PUBLIC SECTOR DOCTORS MARGINAL COST ORGANIZATIONAL PSYCHOLOGY HEALTH ECONOMICS MORBIDITY ECONOMIC REVIEW COST-EFFECTIVENESS INFORMATION MONITORING HEALTH CARE HEALTH CARE WORKERS EFFECTS HEALTH CARE FACILITIES INCENTIVES HEALTH EQUILIBRIUM INFORMAL PAYMENTS HEALTH WORKERS CITIES HEALTH SERVICE UTILIZATION HEALTH FACILITIES HEALTH WORKERS’ PERFORMANCE QUALITY OF HEALTH HEALTH SECTOR KNOWLEDGE CHOICE ECONOMIC PERSPECTIVES COSTS PATIENTS PATIENT INTERVENTION LOW-INCOME COUNTRIES PROBABILITY PRODUCTIVITY IMPACT EVALUATIONS NURSES HEALTH CARE SERVICES OBSERVATION ORGANIZATIONS ANXIETY HEALTH CARE QUALITY HEALTH WORKFORCE STANDARDS HEALTH ORGANIZATION WORK ENVIRONMENT OUTPATIENT SERVICES INTERVIEW MORTALITY FINANCIAL INCENTIVE SOCIAL SUPPORT EFFICIENCY ADMINISTRATIVE COSTS UNEMPLOYMENT HEALTH CARE SECTOR EXTERNALITY PREGNANCY COMPLICATIONS HEALTH SERVICE PROVISION WORKERS WAGES INCENTIVE SCHEMES CROWDING HEALTH-CARE CLINICAL QUALITY VALUE CARE DEMAND HEALTH OUTCOMES HEALTH-CARE PROVIDERS MARGINAL COSTS FAMILY PLANNING STRESS INCOME COUNTRIES BLOOD DONATIONS INTRINSIC MOTIVATION PRIVATE SECTOR MEASUREMENT OPPORTUNITY COSTS NUTRITION ECONOMIC THEORY ECONOMICS PRIMARY HEALTH CARE INTERNET MANAGEMENT HEALTH CARE CENTERS HEALTH SYSTEM WEIGHT PHYSICIANS LOW INCOME THEORY CHILDREN EVALUATION RISK HUMAN RESOURCES ILLNESS SUPPLY COOPERATION REHABILITATION POPULATION STRATEGY NEWBORN HEALTH FEES CHILD HEALTH SERVICES MEDICINES HOSPITALS OUTCOMES BIRTH ATTENDANT HEALTH SERVICE HEALTH SERVICES IMPLEMENTATION PREGNANCY PROVIDER PAYMENT FINANCIAL INCENTIVES ABSENTEEISM HEALTH WORKERS PERFORMANCE HUMAN DEVELOPMENT Lemiere, Christophe Torsvik, Gaute Maestad, Ottar Herbst, Christopher H. Leonard, Kenneth L. Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation
relation	HNP discussion paper series;
description	In order to advance our understanding of why Results Based Financing (RBF) works or not, it is crucial that evaluations not only measure the impact of such an arrangement on final outcomes (population health), but also assess the changes in variables in the causal chain between intervention and final outcomes. Health worker performance is a key variable in this chain; it is only by changing health workers’ behaviors—their performance—that RBF can influence health outcomes. Careful assessment of impacts on health worker performance is therefore a natural and important element of any RBF impact evaluations. This paper discusses various approaches to evaluating the impact of RBF on health worker performance. The first part is a discussion of possible ways in which RBF may affect health worker behavior, based on economic theory and empirical evidence. The second part is a more practical discussion of how health worker performance and other relevant variables can be measured and how impacts can be estimated. This is followed by some practical steps that can be taken to ensure that the evaluation leads to actions that can be implemented; a brief conclusion completes the paper.
format	Working Paper
author	Lemiere, Christophe Torsvik, Gaute Maestad, Ottar Herbst, Christopher H. Leonard, Kenneth L.
author_facet	Lemiere, Christophe Torsvik, Gaute Maestad, Ottar Herbst, Christopher H. Leonard, Kenneth L.
author_sort	Lemiere, Christophe
title	Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation
title_short	Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation
title_full	Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation
title_fullStr	Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation
title_full_unstemmed	Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation
title_sort	evaluating the impact of results-based financing on health worker performance : theory, tools and variables to inform an impact evaluation
publisher	World Bank, Washington, DC
publishDate	2015
url	http://documents.worldbank.org/curated/en/2015/07/24819487/evaluating-impact-results-based-financing-health-worker-performance-theory-tools-variables-inform-impact-evaluation http://hdl.handle.net/10986/22375
_version_	1764450976210616320

Evaluating the Impact of Results-Based Financing on Health Worker Performance : Theory, Tools and Variables to Inform an Impact Evaluation

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