The Design of Incentives for Health Care Providers in Developing Countries : Contracts, Competition, and Cost Control

doi:10.1596/1813-9450-2547

Publication:
The Design of Incentives for Health Care Providers in Developing Countries : Contracts, Competition, and Cost Control

dc.contributor.author	Hammer, Jeffrey S.
dc.contributor.author	Jack, William G.
dc.date.accessioned	2014-09-04T20:34:11Z
dc.date.available	2014-09-04T20:34:11Z
dc.date.issued	2001-02
dc.description.abstract	The authors examine the design and limitations of incentives for health care providers to serve in rural areas in developing countries. Governments face two problems: it is costly to compensate well-trained urban physicians enough to relocate to rural areas, and it is difficult to ensure quality care when monitoring performance is costly or impossible. The goal of providing universal primary health care has been hard to meet, in part because of the difficulty of staffing rural medical posts with conscientious caregivers. The problem is providing physicians with incentives at a reasonable cost. Governments are often unable to purchase medical services of adequate quality even from civil servants. Using simple microeconomic models of contracts and competition, the authors examine questions about: a) The design of rural service requirements and options for newly trained physicians. b) The impact of local competition on the desirable level of training for new doctors. c) The incentive power that can be reasonably expected from explicit contracts. One problem a government faces is choosing how much training to give physicians it wants to send to rural areas. Training is costly, and a physician relocated to the countryside is outside the government's direct control. Should rural doctors face a ceiling on the prices they charge patients? Can it be enforced? The authors discuss factors to consider in determining how to pay rural medical workers but conclude that we might have to set realistic bounds on our expectations about delivering certain kinds of services. If we can identify reasons why the best that can be expected is not a particularly good, it might lead us to explore entirely different policy systems. Maybe it is too hard to run certain decentralized systems. Maybe we should focus on less ambitious but more readily achievable goals, such as providing basic infrastructure.	en
dc.identifier.doi	10.1596/1813-9450-2547
dc.identifier.uri	https://hdl.handle.net/10986/19963
dc.language.iso	en_US
dc.publisher	World Bank, Washington, DC
dc.relation.ispartofseries	Policy Research Working Paper;No. 2547
dc.rights	CC BY 3.0 IGO
dc.rights.uri	http://creativecommons.org/licenses/by/3.0/igo
dc.subject	Health providers
dc.subject	Health services
dc.subject	Rural health services
dc.subject	Health professional education
dc.subject	Medical education
dc.subject	Physicians
dc.subject	Primary health care
dc.subject	Public health care
dc.subject	Incentives
dc.title	The Design of Incentives for Health Care Providers in Developing Countries : Contracts, Competition, and Cost Control	en
dspace.entity.type	Publication
okr.crossref.title	The Design of Incentives for Health Care Providers in Developing Countries: Contracts, Competition, and Cost Control
okr.date.disclosure	2001-03-20
okr.date.doiregistration	2025-04-10T10:53:44.834211Z
okr.doctype	Publications & Research::Policy Research Working Paper
okr.globalpractice	Finance and Markets
okr.globalpractice	Health, Nutrition, and Population
okr.guid	771291468764352419
okr.identifier.doi	10.1596/1813-9450-2547
okr.identifier.report	WPS2547
okr.language.supported	en
okr.sector	Public Administration, Law, and Justice :: Public administration- Health
okr.sector	Health and other social services :: Health
okr.topic	Health, Nutrition and Population::Health Economics & Finance
okr.topic	Health, Nutrition and Population::Health Service Management and Delivery
okr.topic	Health, Nutrition and Population::Health Systems Development & Reform
okr.unit	Public Economics, Development Research Group
relation.isSeriesOfPublication	26e071dc-b0bf-409c-b982-df2970295c87
relation.isSeriesOfPublication.latestForDiscovery	26e071dc-b0bf-409c-b982-df2970295c87