Pay‐for‐performance and dental procedures: A longitudinal analysis of the Brazilian Program for the Improvement of Access and Quality of Dental Specialities Centres. Issue 1 (30th December 2021)

• Record Type: Journal Article
• Authors: Cabreira, Fabiana da Silva; Hugo, Fernando Neves; Celeste, Roger Keller
• Other Names: Celeste Roger Keller guestEditor.; Haye Biazevic Maria Gabriela guestEditor.; Moyses Samuel Jorge guestEditor.
• Is Part Of: Community dentistry and oral epidemiology. Volume 50:Issue 1(2022)
• Page Start: 4
• Page End: 10
• Publication Date: 2021-12-30
• Subjects: dental health services -- health service administration -- incentive reimbursement -- public health dentistry -- specialties, dental; Dental public health -- Periodicals; 617.6
• DOI: 10.1111/cdoe.12717
• Languages: English
• ISSNs: 0301-5661

Abstract

Abstract: Objective: Evaluate the impact of a pay‐for‐performance program on changes in the number of dental procedures performed by public secondary dental care services in Brazil. Methods: A longitudinal study was carried out with 932 public Dental Specialities Centres (Centro de Especialidades Odontológicas – CEO) that participated in the pay‐for‐performance Program for the Improvement of Access and Quality of Dental Specialities Centres Services (PMAQ/CEO) and 379 non‐CEO centres with secondary dental production. The non‐CEO and a group of CEOs did not receive financial incentives from the PMAQ‐CEO and served as control groups. Three CEOs groups received additional financial incentives of 20%, 60% or 100% over maintenance values, based on their performance scores. The outcome was the increase (yes/no) in the number of dental procedures between 2011/2013 and 2015/2017. Analyses were carried out using logistic regressions. Results: The number of specialized procedures increased in 48.4% of the services, 44.6% among non‐CEO, 52.3% among CEO with no financial incentive and 59.1% among CEO with 100% incentive. The fully adjusted model showed that CEOs receiving 100% of the financial incentive had greater odds of increasing the production of dental procedures (OR = 1.65, 95%CI: 1.09–2.51). Services that increased the number of specialist dentists had (OR = 2.35, 95%CI 1.88–2.94). Municipalities that increased in coverage of private dental insurance had OR = 0.98 (95%CI: 0.94–1.02), and those with higher coverage of primary dental care had OR = 1.02 (95%CI: 0.99–1.05). Conclusion: Pay‐for‐performance may increase the production of dental procedures by CEOs, and mechanisms explaining it must be further investigated.