Preferences of healthcare providers for capitation payment in Kenya: a discrete choice experiment

2020
Provider payment mechanisms (PPMs) are important to the universal health coverage (UHC) agenda as they can influence healthcare provider behaviour and create incentives for health service delivery, quality and efficiency. Therefore, when designing PPMs, it is important to consider providers' preferences for PPM characteristics. We set out to uncover senior health facility managers' preferences for the attributes of a capitation payment mechanism in Kenya. We use a discrete choice experiment and focus on four capitation attributes, namely, payment schedule, timeliness of payments, capitation rate per individual per year and services to be paid by the capitation rate. Using a Bayesian efficient experimental design, choice data were collected from 233 senior health facility managers across 98 health facilities in seven Kenyan counties. Panel mixed multinomial logit and latent class models were used in the analysis. We found that capitation arrangements with frequent payment schedules, timelier disbursements, higher payment rates per individual per year and those that paid for a limited set of health services were preferred. The capitation rate per individual per year was the most important attribute. Respondents were willing to accept an increase in the capitation rate to compensate for bundling a broader set of health services under the capitation payment. In addition, we found preference heterogeneity across respondents and latent classes. In conclusion, these attributes can be used as potential targets for interventions aimed at configuring capitation to achieve UHC.
HEALTH POLICY AND PLANNING
页码:842-854|卷号:35|期号:7
ISSN:0268-1080
收录类型
SSCI
发表日期
2020
学科领域
循证公共卫生
国家
肯尼亚
语种
英语
DOI
10.1093/heapol/czaa016
其他关键词
LOGIT-MODELS
EISSN
1460-2237
资助机构
Wellcome TrustWellcome TrustEuropean Commission [101082, 107527, 092654]
资助信息
M.O. and J.K. were funded by a Wellcome Trust grant intermediate fellowship awarded to J.C. (#101082). E.B. was funded by a Wellcome Trust training fellowship (#107527). Wellcome Trust core grant (#092654) awarded to KEMRIjWellcome Trust Research Programme also funded this research. G.A.A. is a fulltime staff of the University for Development Studies in Ghana. Additionally, the funders and the World Bank had no role in the design of the study, data analysis, decision to publish, drafting, or submission of the manuscript.
被引频次(WOS)
0
被引更新日期
2022-01
来源机构
The World Bank University of Sydney University of Oxford
关键词
Capitation discrete choice experiment provider payment mechanism strategic purchasing