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Provider Performance Incentives for Anti-Retroviral Treatment

Health & Psychology Rwanda
An AIDS awareness billboard in Rwanda. Credit: Wikimedia Commons

To date little is known about the effect of provider Pay-for-Performance (P4P) on HIV outcomes in developing world. The purpose of this study was to assess the impact of financial incentives for providers on HIV treatment continuity, therapy adherence, and health status for people living with HIV/AIDS. The identification strategy used a difference-in-difference approach exploiting the geographic phase-in of P4P contracting over time. In addition, the team constructed a synthetic control group by matching on pre-intervention trends. Data include clinical medical records from patient visits, collected by the Government of Rwanda, as well as Demographic and Health Surveys linked to administrative data on Rwanda’s roll-out of P4P. The researchers found a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage points among discordant couples in which only one of the partners is an AIDS patient.

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