How Promising Is Pay for Quality in Health-Care Systems Reform?

Pay for Performance or Pay for Quality (P4P or P4Q) is defined as ‘the systematic and deliberate use of financial incentives that recognises and rewards the highest levels of quality and quality improvement’. Even if we find several studies that show that this payment system can have positive effects on the health of patients, this brief review shows that there are many issues, problems and unanswered questions related to its implementation. Therefore it is important for those who want to introduce P4Q to learn from the success stories in order to avoid making the same mistakes as in projects that have failed. A permanent point of attention should be on the impact of P4Q on equal access to high quality care.