The effect of financial incentives on health care providers

Key message

Financial incentives are used to affect behaviour. The objective of this rapid review was to provide an updated overview of systematic reviews that assess the effect of financial incentives to providers within health- and social care in high and middle income countries. Our starting point was two published umbrella reviews which we updated.

We conducted an update of the systematic literature search, and identified another four reviews. We extracted data and presented the results organised according to financial incentives included. At present, nine reviews are included, however, with a considerable degree of overlap of included financial incentives:

• Salary
• Capitation
• Fee-for-service
• Target payment
• Fundholding
• Reimbursement
• Return-of-service

The quality of the documentation of these financial incentives included in these reviews was low to very low. The low quality of evidence is largely a result of the fact that most of the comparisons were only investigated in one small study. Additionally, many of these studies had methodological challenges.

The available evidence is of too low quality to determine if the included financial incentives have an effect on health- or social care provider’s behaviour.