Filenews by Marilena Panayi - 3 January 2025
Incentives and disincentives for gynaecologists are provided by the Health Insurance Organisation Scheme, which was piloted yesterday as part of the Ministry of Health's strategy to reduce the number of unnecessary caesarean sections performed in Cyprus.
Based on the plan and when the pilot implementation period ends, gynaecologists of the General Health System will be able to receive a reward, i.e. get more money, if they keep the number of caesarean sections they perform within set limits, but at the same time they will see a reduction in their earnings by up to 35% in cases where they exceed, in a specific percentage, the limits set by the HIO.
It is stated that the Plan will apply in cases of uncomplicated caesarean sections, that is, caesarean sections performed due to a real need for the protection of mother and child will not be taken into account.
Specifically, and according to the information that gynaecologists received from the HIO, a reward of 5% to 15% will be given when: (The calculation will be made on the births performed by each doctor in a hospital)
- The doctor who performs <30% of uncomplicated caesarean sections compared to the total deliveries performed in the previous months at the said hospital, will receive a reward of 15% on the total income of all deliveries performed in the said hospital
- The doctor who performs 30.01% – 40% of uncomplicated caesarean sections compared to the total deliveries performed in the previous months at the said hospital, will receive a reward of 5% on the total income of all deliveries performed in the said hospital.
No impact, i.e. no reward will be given but no fine will be imposed when the gynaecologist performs 40.01% – 50% caesarean sections compared to the total deliveries he will have performed in the previous months.
From this point on, however, the HIO will impose fines, or more correctly, doctors will accept discounts on their salaries. The discounts will be staggered and depending on the percentage of uncomplicated caesarean sections performed by the doctor in a specific hospital.
Analytically:
- A doctor who will perform 50.01% – 60% of uncomplicated caesarean sections compared to the total deliveries performed in the previous months, will accept a 5% discount on half the income of the uncomplicated caesarean sections performed at the said hospital
- A doctor who performs 60.01%-70% of uncomplicated caesarean sections compared to the total deliveries performed in previous months will receive a 10% discount on half the income of the uncomplicated caesarean sections performed at the said hospital
- A doctor who will perform 70.01%-80% uncomplicated caesarean sections will accept a 15% discount on half the income of the uncomplicated caesarean sections performed at the said hospital
- A doctor who performs 80.01%-90% of uncomplicated caesarean sections will receive a 25% discount on half of the income of the uncomplicated caesarean sections performed at the said hospital
- A doctor who performs >90% of uncomplicated caesarean sections compared to all deliveries will receive a 35% discount on half the income of the uncomplicated caesarean sections performed at the hospital.
For the proper implementation of the Plan, the HIO, as the gynaecologists were informed, "will monitor the rates of performing uncomplicated caesarean sections against the total deliveries per doctor per hospital. As a result of this evaluation, every month the doctor and the hospital will receive a cumulative status of this percentage."
As the HIO points out, "doctors operating in more than one hospital will receive a separate statement for their percentage per hospital, while hospitals will receive a list that will include the rates of performing uncomplicated caesarean sections per doctor they collaborate with/employ".
The Plan will be fully implemented immediately upon completion of the clinical guideline for caesarean section currently being developed by the Agency. The Directive is expected to be ready within the first quarter of 2025.
