Incentives to reduce C-section rates introduced

The health ministry and the Health Insurance Organisation (HIO) have prepared a plan to incentivise gynaecologists and obstetricians to perform natural births instead of caesareans (C-sections), it emerged on Wednesday.

Under the plan, doctors performing natural births will receive incentives, while those performing C-sections over a certain quota will be penalised. The plan, currently under discussion with doctors, proposes that those who keep the number of uncomplicated C-sections they perform within certain limits will receive up to a 15 per cent increase in their compensation. Conversely, those who exceed the set limits will face reductions in their compensation, with reductions reaching up to 35 per cent in extreme cases.

According to data from the health ministry, the rate of C-sections in Cyprus in 2021 reached 59 per cent, compared to the EU average of below 30 per cent.

In 2022, out of 10,373 total births in Cyprus, 60 per cent were performed via C-section. By 2023, the Gesy system showed that the percentage of C-sections had increased to 62.31 per cent, while the EU average remained below 30 per cent.

Data presented by the ministry to the House Health Committee in October 2022 revealed that in 2021, only 15-17 per cent of C-sections were performed to save the mother and child. Another 40 per cent were planned, and 38 per cent were recorded as being by the mother’s choice.

Citing the data analysed through Gesy software, the HIO presented its plan to the doctors.

HIO said: “HIO will monitor monthly the rates of performing uncontrolled caesarean sections against the total number of deliveries per doctor, per hospital. Each month the physician and nursing facility will receive a cumulative statement of that rate. At the end of each year, the agency will award incentives or penalties to the clinics that compensate doctors.”

Under the plan, a doctor who records a percentage of uncomplicated C-sections below 30% of the total deliveries will receive a 15 per cent bonus on the total income of all deliveries performed in that hospital (if a doctor collaborates with more than one hospital, the bonus will be cumulative).

A doctor who performs 30-40 per cent of uncomplicated C-sections will receive a 5 per cent reward on the total income of all deliveries performed. Meanwhile, a doctor who exceeds 40 per cent will receive a penalty on half of the income from the uncomplicated C-sections performed.

If the percentage of uncomplicated C-sections is between 60-70 per cent, the penalty will be a 10 per cent reduction, increasing to 15 per cent for 70-80 per cent, and up to 35 per cent for performing C-sections more than 90 per cent of the time.