Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme – a systems approach

by Irene A Agyepong, Geneieve C Aryeetey, Justice Nonvignon et al.
Health Research Policy and Systems 2014, 12:35 (5 August 2014)

31 pp. 2.9 MB:
http://www.health-policy-systems.com/content/pdf/1478-4505-12-35.pdf

The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear perspectives, since the latter fail to recognize the effects of context and the between-methods and context interactions in producing net effects.

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