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A performance-based incentive program for influenza immunization in the elderly

R W Kouides1, B Lewis, N M Bennett

  • 1Department of Medicine, Genesee Hospital, Rochester, NY 14607.

American Journal of Preventive Medicine
|July 1, 1993
PubMed
Summary
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Performance-based reimbursement significantly increased influenza immunization rates in elderly patients. Financial incentives for physicians achieving over 70% vaccination rates proved effective in a community setting.

Area of Science:

  • Public Health
  • Health Services Research
  • Geriatric Medicine

Background:

  • Influenza immunization is crucial for elderly health.
  • Current immunization rates in the elderly often fall below recommended targets.
  • Physician reimbursement models may influence vaccination uptake.

Purpose of the Study:

  • To evaluate the impact of performance-based reimbursement on influenza immunization rates among the elderly.
  • To assess the effectiveness of financial incentives for primary care physicians.
  • To identify factors associated with higher immunization levels in physician practices.

Main Methods:

  • A community-based quasi-experimental design was employed in Monroe County, New York.
  • Intervention group: 53 physicians in a performance-based incentive program (target >70% immunization).

Related Experiment Videos

  • Comparison group: 82 physicians without the incentive; data collected during the 1990-1991 season.

    • Main Results:

    • The incentive group achieved an average immunization rate of 73.1%, significantly higher than the comparison group's 55.7% (P < .001).
    • Regression analysis confirmed that eligibility for the incentive remained a significant predictor of higher immunization rates (P = .003), even after controlling for other variables.
    • Factors like practice size and patient population characteristics were also associated with immunization levels, while reminder postcards showed a negative influence.

    Conclusions:

    • Linking physician reimbursement to performance can be an effective strategy to improve influenza immunization rates in the elderly.
    • Financial incentives appear to be a viable tool for enhancing public health vaccination efforts.
    • Further research could explore optimal incentive structures and address barriers to immunization.