The influence of performance-based payment on childhood immunisation coverage

Area of Science:

• Public Health
• Health Economics
• Pediatrics

Background:

• Estonia implemented a pay-for-performance (quality system) in 2006.
• Childhood immunisation coverage is a key performance indicator for the quality system.
• The World Health Organization recommends vaccination coverage of at least 90% for specific childhood vaccines.

Purpose of the Study:

• To evaluate the impact of Estonia's quality system on childhood immunisation coverage rates.
• To compare immunisation coverage between family physicians participating in the quality system and those who are not.

Main Methods:

• Utilized data from the Estonian Health Insurance Fund (2006-2012).
• Compared immunisation coverage rates for children around one year old among Estonian family physicians.
• Categorized physicians into two groups: those joined to the quality system and those not joined.

Main Results:

• Significant differences in immunisation coverage were observed between the two groups.
• Family physicians in the quality system achieved the 90% vaccination target more frequently.
• Physicians not participating in the quality system consistently fell below the 90% vaccination benchmark for all scheduled immunisations.

Conclusions:

• Pay-for-performance financial incentives positively influence childhood immunisation rates.
• The quality system in Estonia appears effective in promoting higher vaccination coverage.
• Financial incentives can be a tool to improve public health outcomes in childhood immunisation programs.