Benabbas Roshanak, Shan Gururaj, Akindutire Olumide, Mehta Ninfa, Sinert Richard
Department of Emergency Medicine, State University of New York Downstate Medical Center, and Department of Emergency Medicine, Kings County Hospital Center, Brooklyn, New York.
Qual Manag Health Care. 2019 Jul/Sep;28(3):155-162. doi: 10.1097/QMH.0000000000000219.
Pay-for-performance (P4P) is broadly defined as financial incentives to providers for attaining prespecified quality outcomes. Providers, payers, and public officials have worked over the years to develop innovative solutions to rapidly and consistently bring new diagnostic tests and therapies to our patients. P4P has been instituted in various forms over the last 30 years. Vaccines are one of society's greatest public health innovations and vaccination programs provide a unique opportunity for P4P programs. We attempted to investigate the effect of P4P compensation model implementation on the vaccination rate.
Utilizing a systematic review and meta-analysis approach, we searched PubMed, Embase, Scopus, and Web of Science from inception to December 2018.
Nine articles were included with poor to moderate quality. Improvements in vaccination rates after implementation of P4P were statistically significant in 8 of 9 of studies. However, due to the heterogeneity of the methods used, we could not pool the data.
The results of this systematic review indicate that the implementation of P4P programs can increase the vaccination rate. In recent times when it has become increasingly more popular not to vaccinate, implementing P4P becomes even more important if it is shown to be an effective tool in increasing vaccination rates.
绩效薪酬（P4P）被广泛定义为向提供者提供经济激励，促使其实现预先设定的质量成果。多年来，提供者、支付方和政府官员一直致力于开发创新解决方案，以便迅速且持续地为患者带来新的诊断测试和治疗方法。在过去30年里，P4P已以各种形式实施。疫苗是社会最伟大的公共卫生创新之一，疫苗接种计划为P4P计划提供了独特的机会。我们试图研究实施P4P补偿模式对疫苗接种率的影响。
我们采用系统评价和荟萃分析方法，检索了自数据库建立至2018年12月的PubMed、Embase、Scopus和Web of Science数据库。
纳入9篇质量从低到中等的文章。在9项研究中的8项研究里，实施P4P后疫苗接种率的提高具有统计学意义。然而，由于所使用方法的异质性，我们无法汇总数据。
本系统评价结果表明，实施P4P计划可提高疫苗接种率。在近来不接种疫苗变得越来越普遍的情况下，如果P4P被证明是提高疫苗接种率的有效工具，那么实施P4P就变得更加重要。
