The Utilisation of Payment Models Across the HIV Continuum of Care: Systematic Review of Evidence.

Rua, Tiago; Brandão, Daniela; Nicolau, Vanessa; Escoval, Ana

The increasing chronicity and multimorbidities associated with people living with HIV have posed important challenges to health systems across the world. In this context, payment models hold the potential to improve care across a spectrum of clinical conditions. This study aims to systematically review the evidence of HIV performance-based payments models. Literature searches were conducted in March 2020 using multiple databases and manual searches of relevant papers. Papers were limited to any study design that considers the real-world utilisation of performance-based payment models applied to the HIV domain. A total of 23 full-text papers were included. Due to the heterogeneity of study designs, the multiple types of interventions and its implementation across distinct areas of HIV care, direct comparisons between studies were deemed unsuitable. Most evidence focused on healthcare users (83%), seeking to directly affect patients' behaviour based on principles of behavioural economics. Despite the variability between interventions, the implementation of performance-based payment models led to either a neutral or positive impact throughout the HIV care continuum. Moreover, this improvement was likely to be cost-effective or, at least, did not compromise the healthcare system's financial sustainability. However, more research is needed to assess the durability of incentives and its appropriate relative magnitude.

HIV-positive persons; HIV infections; ONLINE information services; MEDICAL databases; INFORMATION storage & retrieval systems; SYSTEMATIC reviews; MEDICAL care; PATIENTS; BEHAVIOR; MEDICAL care costs; CONTINUUM of care; LABOR incentives; DESCRIPTIVE statistics; COST effectiveness; QUALITY assurance; PAY for performance; MEDLINE; ECONOMIC aspects of diseases; AIDS; COMORBIDITY

AIDS & Behavior, 2021, Vol 25, Issue 12, p4193

1090-7165

Academic Journal

10.1007/s10461-021-03329-2