Individual performance-based incentives for health care workers in Organisation for Economic Co-operation and Development member countries : a systematic literature review

Lin, T.K. and Werner, K. and Witter, S. and Alluhidan, M. and Alghaith, T. and Hamza, M.M. and Herbst, C.H. and Alazemi, N. (2022) Individual performance-based incentives for health care workers in Organisation for Economic Co-operation and Development member countries : a systematic literature review. Health Policy, 126 (6). pp. 512-521. ISSN 0168-8510

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Abstract

In response to rising costs and growing concerns about safety, quality, equity and affordability of health care, many countries have now developed and deployed performance-based incentives, targeted at facilities as well as individuals. Evidence of the effect of these efforts has been mixed; it remains unclear how effective strategies of varying design and magnitude (relative to provider salary) are at incentivizing individual-level performance. This study reviews the current evidence on effectiveness of individual-level performance-based incentives for health care in Organisation for Economic Co-operation and Development countries, which are relatively well situated to implement, monitor and evaluate performance-based incentives programs. We delineate the conditions under which sanctions or rewards – in the context of gain-seeking, loss aversion, and increased social pressure to modify behaviors – may be more effective. We find that programs that utilized positive reinforcement methods are most commonly observed – with slightly more overall bonus incentives than payment per output or outcome achieved incentives. When comparing the outcomes from negative reinforcement methods with positive reinforcement methods, we found more evidence that positive reinforcement methods are effective at improving health care worker performance. Overall, just over half of the studies reported positive impacts, indicating the need for care in designing and adopting performance-based incentives programs. © 2022 The Author(s)

Item Type:
Journal Article
Journal or Publication Title:
Health Policy
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2719
Subjects:
?? health care workersorganisation for economic co-operation and developmentpay for performanceperformance based incentivescosts and cost analysisdelivery of health carehealth personnelhumansmotivationorganisation for economic co-operation and developmentend ??
ID Code:
237249
Deposited By:
Deposited On:
12 May 2026 09:00
Refereed?:
Yes
Published?:
Published
Last Modified:
12 May 2026 09:00