Supporting files for: Performance bonuses and the quality of primary health care delivered by family health teams in Brazil: A difference-in differences analysis

Powell-Jackson, T, Fardousi, N, da Silva, E, Kovacs, R, Borghi, J, Barreto, J, Søren, K, Sampaio, J, Shimizu, HE, Gomes, L, Letícia, X and Garibaldi, G. 2022. Supporting files for: Performance bonuses and the quality of primary health care delivered by family health teams in Brazil: A difference-in differences analysis. [Online]. London School of Hygiene & Tropical Medicine, London, United Kingdom. Available from: https://doi.org/10.17037/DATA.00002886.

Powell-Jackson, T, Fardousi, N, da Silva, E, Kovacs, R, Borghi, J, Barreto, J, Søren, K, Sampaio, J, Shimizu, HE, Gomes, L, Letícia, X and Garibaldi, G. Supporting files for: Performance bonuses and the quality of primary health care delivered by family health teams in Brazil: A difference-in differences analysis [Internet]. London School of Hygiene & Tropical Medicine; 2022. Available from: https://doi.org/10.17037/DATA.00002886.

Powell-Jackson, T, Fardousi, N, da Silva, E, Kovacs, R, Borghi, J, Barreto, J, Søren, K, Sampaio, J, Shimizu, HE, Gomes, L, Letícia, X and Garibaldi, G (2022). Supporting files for: Performance bonuses and the quality of primary health care delivered by family health teams in Brazil: A difference-in differences analysis. [Data Collection]. London School of Hygiene & Tropical Medicine, London, United Kingdom. https://doi.org/10.17037/DATA.00002886.

Description

Description of data capture Pay-for-performance programmes to incentivise health providers to improve quality of care have been widely implemented globally. Despite intuitive appeal, evidence on the effectiveness of P4P is mixed, potentially due to differences in how schemes are designed. We exploited municipality variation in the design features of Brazil’s National Programme for Improving Primary Care Access and Quality (PMAQ) to examine whether performance bonuses given to family health team workers were associated with changes in the quality of care and whether the size of bonus mattered. We used a difference-in-differences approach combined with matching. We compared changes over time in the quality of care delivered by family health teams between (bonus) municipalities that chose to use some or all of the PMAQ money to provide performance-related bonuses to team workers with (non-bonus) municipalities that invested the funds using traditional input-based budgets. The primary outcome was the PMAQ score, a quality of care index on a scale of 0 to 100, based on several hundred indicators (ranging from 598 to 660) of healthcare delivery. We did one-to-one matching of bonus municipalities to non-bonus municipalities based on baseline demographic and economic characteristics. On the matched sample, we used ordinary least squares regression to estimate the association of any bonus and size of bonus with the pre-post change over time (between November 2011 and October 2015) in the PMAQ score. We performed subgroup analyses with respect to the local area income of the family health team. We provide the analysis dataset, analysis code and the codebook that underpinned the study. The analysis dataset combines data from five different sources. First, we obtained the PMAQ score and performance category of all family health teams in each implementation round from the Ministry of Health. Second, to capture variation in the design of PMAQ, we used data from an online survey of municipality health managers, conducted as part of the external evaluation in the third round of implementation. This survey asked various questions on incentive design, including whether the municipality passed on PMAQ funds as bonuses to family health team workers and the size of the bonuses as a percentage of staff salaries. Third, we used the 2010 Brazilian Population Census to measure the average monthly income of households in each census area. We geographically linked each health facility to a census sector, allowing us to measure the local area income of each family health team. Fourth, we obtained data on the characteristics of health facilities to which family health teams were attached from a census of health facilities done by the Ministry of Health in 2011. Fifth, we used established sources to construct a dataset of municipality socioeconomic and demographic characteristics for the year 2010. Some of the data used in the study are owned by the Ministry of Health in Brazil and we do not have permission to share the data publicly. These variables are not available in the dataset. Instead, for these restricted data, we generate placeholder variables using a random number generator to allow the do file to run and for illustration.
Data capture method Aggregation
Data Collection Period
FromTo
20112016
Date (Completed) 3 May 2022
Geographical area covered
North LatitudeEast LongitudeSouth LatitudeWest Longitude
6.23202-28.9515-31.7247-67.7991
Language(s) of written materials English
Data Creators Powell-Jackson, T, Fardousi, N, da Silva, E, Kovacs, R, Borghi, J, Barreto, J, Søren, K, Sampaio, J, Shimizu, HE, Gomes, L, Letícia, X and Garibaldi, G
LSHTM Faculty/Department Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre Centre for Evaluation
Research Group Global Health Economics Centre
Participating Institutions London School of Hygiene & Tropical Medicine, London, United Kingdom, University of Brasília, Brasília, Brazil, Oswaldo Cruz Foundation-Fiocruz, Brasilia, Brazil, Centre for Health Economics, University of Southern Denmark, Odense, Denmark, Department of Health Promotion, Federal University of Paraiba, João Pessoa, Paraiba, Brazil, Federal University of Grande Dourados, Mato Grosso do Sul, Brazil, Oswaldo Cruz Foundation-Fiocruz, Pernambuco, Brazil
Funders
ProjectFunderGrant NumberFunder URI
Unpacking the effect of the national pay for performance scheme (PMAQ) on inequalities in the financing and delivery of primary care in BrazilMedical Research CouncilMR/R022828/1http://dx.doi.org/10.13039/501100000265
Date Deposited 04 May 2022 10:55
Last Modified 04 May 2022 10:56
Publisher London School of Hygiene & Tropical Medicine

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Filename: pmaq_analytical_data.dta

Description: Dataset for PMAQ performance bonuses (STATA format). Restricted data are not available in the dataset

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Description: Codebook for PMAQ performance bonuses dataset

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Description: User guide for PMAQ performance bonuses dataset

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