5. Effect of all included randomised trials.
| Comparison 1: P4P plus existing payment methods compared withexisting payment methods | ||||
| Study | Outcome measures | Control/baseline level | Absolute change | Relative change |
| Quantity of health services provided | ||||
| Fairbrother 1999 | UTD immunisation rate (adjusted by baseline) | 12.6% | 12.7% | +140.77% |
| Fairbrother 2001 | UTD immunisation rate (adjusted by baseline) | −2.5% | 8.4% | −336% |
| Kouides 1998 | Immunisation rate | 4.7 | 6.3% | +134.04% |
| Christensen 2000 | Documentation rate of CS per 100 Medicaid prescriptions | 0.67% | 0.92% | +137.31% |
| CS intervention time per 100 Medicaid prescriptions | 6.5% | 1.4% | +21.54% | |
| Synthesised effects inside the study (median) | ‐ | 1.16% | +79.43% | |
| Synthesised effect across the above 4 studies (median) | ‐ | ‐ | +134.04% | |
| Quality of health services provided | ||||
| Petersen 2013 | Use of guideline | 0.47% | 8.37% | +1780.85% |
| Patient outcomes | ||||
| Petersen 2013 | Blood pressure control or appropriate response | 4.35% | 4.72% | +108.51% |
| Houle 2016 | Systolic BP level reduction | 17.0 | 2.7 | +15.88% |
| Diastolic BP level reduction | 8.2 | −0.6 | −7.32% | |
| Synthesised effects inside the study (median) | ‐ | 1.05 | +4.28% | |
| Synthesised effect across the above 2 studies (median) | ‐ | ‐ | +15.88% | |
| Comparison 2: FFS compared withexisting payment methods | ||||
| Study | Outcome measures | Control/baseline level | Absolute change | Relative change |
| Quantity of health services | ||||
| Davidson 1992 | Primary care physician visits | −0.33 | 0.36 | −61.02% |
| Non‐primary visit | −0.05 | 0.23 | −460% | |
| Clinic visits | −0.47 | −0.05 | +10.64% | |
| Hospitalisation | −0.042 | −0.0276 | +65.71% | |
| Synthesised effects inside the study (median) | ‐ | ‐ | −25.19% | |
| Lurie 1992 | Proportion of receiving outpatient | 61% | 10% | +16.39% |
| Over average inpatient admissions | 0.20 | 0.19 | +95% | |
| Proportion of outpatient chemical depending treatment | 4.5% | 5.8% | +128.89% | |
| Proportion of inpatient chemical depending treatment | 1.9% | 3.3% | +173.68% | |
| Length of stays | 1.56 | 2.74 | +175.64% | |
| Proportion of being refused | 17% | −5% | −29.41% | |
| Synthesised effects inside the study (median) | ‐ | ‐ | +111.95% | |
| Hickson 1987 | Average number of patient/physician | 43.4 | 11.7 | +26.96% |
| Average number of visits attended/physician | 111.6 | −6.8 | −6.09% | |
| % attended by primary physician | 86.6% | −8.3% | −9.58% | |
| Emergency visit | 0.12 | 0.1 | +83.33% | |
| Synthesised effects inside the study (median) | ‐ | ‐ | +10.44% | |
| Synthesised effect across the above 3 studies (median) | ‐ | ‐ | +10.44% | |
| Patient outcomes | ||||
| Lurie 1992 | Self‐rated health | 3.0% | −3.7% | +123.33% |
| General health status | 0.2 | −0.2 | +100.% | |
| Physical functioning index | 0 | 0 | 0 | |
| Social contact | −0.7 | 1.2 | −171.43% | |
| Mean Global Assessment Scale for psychiatric status | −1 | −0.3 | −30% | |
| Depression | −0.8 | 2.9 | −362.5% | |
| Anxiety | 0.2 | 0.7 | +350% | |
| Endogenous features | 0.7 | 0.5 | +71.43% | |
| Mania | 0.2 | −0.6 | −3% | |
| Delusions | 0.2 | 0 | 0 | |
| Miscellaneous | 0.1 | 0.4 | +80% | |
| Arrested | 0.3 | 1 | −333.33% | |
| Jailed | 0 | −1.1 | 0 | |
| Assaulted | 1.3 | −6.4 | −492.31% | |
| Suicide | −1.2 | 0.2 | −16.67% | |
| Living in sheltered setting | −1.9 | −3.1 | −147.62% | |
| With nights homeless during previous year | −0.3 | 1 | −333.33% | |
| Working in sheltered setting | −0.2 | 0.1 | −100% | |
| Synthesised effects inside the study (median) | ‐ | 0.05 | −9.84% | |
| Comparison 3: FFS mixed payment methods compared withsingle payment method | ||||
| Study | Outcome measures | Control/baseline level | Absolute change | Relative change |
| Quantity of health services provided | ||||
| Bilardi 2010 | Proportion of patients tested | 2.6% | −0.7% | −26.92% |
| Clarkson 2008 | Percentage of children with at least 1 sealant treatment per dentist | 26.3% | 6.6% | +25.1% |
| Synthesised effect across the above 2 studies (median) | ‐ | ‐ | −0.91% | |
| Patient outcomes | ||||
| Twardella 2007 | Self‐reported smoking abstinence | 0.12% | 0.03% | +25% |
| Comparison 4: Enhanced FFS compared with FFS | ||||
| Study | Outcome measures | Control/baseline level | Absolute change | Relative change |
| Quantity of health services | ||||
| Davidson 1992 | Primary care physician visits | −0.59 | 0.56 | −94.92% |
| Non‐primary visit | 0.19 | −0.37 | −194.74% | |
| Clinic visits | −0.34 | −0.18 | +52.94% | |
| Hospitalisation | −0.0312 | −0.0384 | +123.08% | |
| Synthesised effects inside the study (median) | ‐ | −0.1092 | −20.99% | |
| Fairbrother 1999 | UTD immunisation rate | 12.6% | −8.3 | −65.87% |
| Fairbrother 2001 | UTD immunisation rate | −2.5% | 9.9% | −396% |
| Synthesised effects across the above 3 studies (median) | ‐ | ‐ | −65.87% | |
BP: blood pressure CS: cognitive services FFS: fee‐for‐service P4P: pay for performance UTD: up‐to‐date