Does a pay-for-performance program for primary care physicians alleviate health inequity in childhood vaccination rates?

摘要: Childhood vaccination rates in Manitoba populations with low socioeconomic status (SES) fall significantly below the provincial average. This study examined impact of a pay-for-performance (P4P) program called Physician Integrated Network (PIN) on health inequity childhood rates. The used administrative data housed at Centre for Health Policy. We included all children born between 2003 and 2010 who were patients PIN clinics receiving P4P funding matched controls non-participating clinics. rate completion primary series by age 2 across income quintiles (Q1–Q5). estimated distribution using Gini coefficient, calculated concentration indices to determine whether altered SES-related differences completion. compared these measures cohorts before after implementation program, over course each cohort. cohort 6,185 children. Rates baseline 0.53 (Q1) 0.69 (Q5). Inequality was present end control cohorts. worsened non-PIN (difference index 0.037; 95 % CI 0.013, 0.060), but remained constant P4P-funded 0.006; 0.008, 0.021). had limited did not address inequity.