Effect of payment for performance on quality of care in the short and long term (results from the difference-in-difference analysis)
| Outcome variables | N | Short-term effect | Difference between short and long term | Long-term effect | |||
| Beta* (95% CI) | P value | Beta* (95% CI) | P value | Beta* (95% CI) | P value | ||
| Targeted services | |||||||
| ANC content of care index | 1090 | −0.06 (−0.14 to 0.02) | 0.121 | 0.01 (−0.06 to 0.08) | 0.818 | −0.01 (−0.09 to 0.06) | 0.688 |
| Index of patient satisfaction with interpersonal care for targeted outpatient services | 2049 | 0.04 (−0.01 to 0.09) | 0.146 | −0.05 (−0.10 to −0.01) | 0.025 | −0.02 (−0.06 to 0.02) | 0.343 |
| Index of patient satisfaction with interpersonal care during deliveries | 7648 | 0.01 (−0.02 to 0.04) | 0.505 | 0.02 (−0.01 to 0.05) | 0.127 | 0.04 (0.00 to 0.07) | 0.035 |
| Patient assessment of staff kindness during delivery score (1–10) | 7627 | 0.38 (−0.06 to 0.82) | 0.088 | 0.03 (−0.36 to 0.41) | 0.885 | 0.41 (0.06 to 0.76) | 0.019 |
| Waiting time in minutes | 2003 | 6.3 (−16.5 to 29.2) | 0.585 | −18.1 (−37.8 to 1.6) | 0.072 | −13.0 (−32.5 to 6.5) | 0.190 |
| Consultation time in minutes | 1985 | −0.8 (−4.5 to 2.9) | 0.656 | −0.4 (−2.9 to 2.6) | 0.759 | −0.6 (−1.7 to 0.5) | 0.278 |
| Non-targeted services | |||||||
| Index of patient satisfaction with interpersonal care | 1779 | 0.05 (0.01 to 0.10) | 0.031 | −0.06 (−0.11 to −0.01) | 0.030 | 0.00 (−0.01 to 0.02) | 0.850 |
| Waiting time in minutes | 1719 | −9.3 (−28.3 to 9.6) | 0.331 | −11.3 (−30.2 to 7.6) | 0.238 | −18.0 (−35.0 to −0.9) | 0.038 |
| Consultation time in minutes | 1716 | −0.04 (−2.9 to 2.9) | 0.977 | −2.1 (−4.7 to 0.4) | 0.098 | −1.9 (−5.0 to 1.0) | 0.197 |
| Availability of drugs, supplies and equipment at the facility | |||||||
| Drug availability index (%) | 437 | 8.4 (3.0 to 13.7) | 0.002 | −4.4 (−9.4 to 0.5) | 0.083 | 3.6 (−1.5 to 9.1) | 0.153 |
| Drug stock out index (%) | 437 | −13.6 (−22.1 to −5.1) | 0.002 | 3.8 (−3.0 to 10.5) | 0.273 | −9.6 (−16.2 to −3.1) | 0.04 |
| Antimalarials availability (%)† | 437 | 20.5 (11.8 to 29.3) | 0.000 | −8.4 (−18.0 to 1.1) | 0.083 | 11.7 (2.3 to 21.1) | 0.015 |
| Antimalarials stock-out (%)† | 437 | −10.5 (−21.6 to 0.6) | 0.064 | 10.4 (−0.1 to 20.9) | 0.052 | 0.6 (−0.1 to 20.9) | 0.922 |
| Delivery care drugs avail (%)‡ | 437 | 11.8 (3.8 to 19.8) | 0.004 | −5.0 (−12.0 to 1.9) | 0.154 | 7.0 (−0.1 to 14.1) | 0.052 |
| Delivery care drugs stock out (%)‡ | 437 | −24.7 (−38.4 to −11.0) | 0.000 | 6.0 (−4.7 to 16.8) | 0.270 | −19.0 (−29.3 to −8.6) | 0.001 |
| Medical supplies availability (%) | 444 | 8.3 (0.01 to 16.5) | 0.050 | 2.4 (−3.9 to 8.7) | 0.461 | 10.6 (1.8 to 19.4) | 0.018 |
| Medical supplies stock out (%) | 428 | −13.1 (−23.1 to −3.2) | 0.010 | 0.3 (−7.2 to 7.9) | 0.927 | −12.3 (−21.5 to −2.8) | 0.010 |
| Availability of medical equipment (%) | 444 | 3.8 (−4.9 to 12.6) | 0.391 | 1.7 (−7.7 to 11.1) | 0.727 | 5.7 (−1.9 to 13.2) | 0.140 |
*The beta is the estimated intervention effect controlling for a year dummy, facility-fixed effects, individual-level and household characteristics.
†Artemether-Lumefantrine (ALU) and Sulfadoxine-pyrimethamine (SP).
‡Oxytocics+antihypertensives (magnesium sulfate, diazepam, aldomet, nifedipine, and hydralazine.
ANC, antenatal care; PNC, postnatal care; SP, sulfadoxine–pyrimethamine.