Title:

Health care provider payment schemes : a comparative analysis of reform trends

Author:

Ndayishimiye, Costase

Subject:

healthcare providers ; payment systems ; performancebased financing ; Central and Eastern Europe ; African Commonwealth Countries

Abstract:

This dissertation examines recent trends in healthcare provider payment reforms, focusing on barriers and facilitators across different regions, particularly Central and Eastern European (CEE) and African Commonwealth countries. It includes five interconnected studies: a global scoping review, a cross-country analysis of CEE payment schemes, a thematic analysis of CEE reforms, a scoping review of African Commonwealth reforms, and an in-depth study of Rwanda's performance-based financing (PBF) program. Key findings highlight common barriers such as provider resistance and inadequate funding, while facilitators include political commitment and stakeholder engagement. In CEE, output-based payment models dominate, with trends towards blended models incorporating performance-based incentives. In African Commonwealth countries, PBF and mixed models are common, with Rwanda’s PBF improving provider accountability and patient outcomes. The dissertation stresses the importance of reform content, implementation processes, and stakeholder involvement. It advocates for tailored, holistic strategies to overcome challenges and ensure sustainable reforms, contributing valuable insights for future healthcare financing research and policy.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree grantor:

Rada Dyscypliny Nauki o zdrowiu

Promoter:

Dubas-Jakóbczyk, Katarzyna ; Tambor, Marzena

Date:

2025

Date issued:

2025

Type:

Praca doktorska

Call number:

ZB-143570

Language:

eng

Access rights:

nieograniczony