新西兰卫生部长Simeon Brown宣布推出一项基于绩效的激励计划，拨款4000万纽元用于奖励达到特定卫生目标的全科医生诊所1。该计划涵盖四项主要指标：婴幼儿完全免疫率达到90%、女性宫颈癌筛查率最新达到80%、为25%的吸烟者提供戒烟支持，以及建立在线预约门户1。
然而，学术界对这一举措提出了关注。统一的绩效目标可能对服务贫困社区的诊所构成不公平的负担。以奥克兰Calder Centre为例，该诊所服务高风险流动人口，面临更大的实现目标难度1。地区间的现状差异也很显著，北地平均免疫率仅为64%，而坎特伯雷已达到88%1。
专家警告称，这类基于目标的激励机制可能导致"打勾医疗"现象，即诊所优先重视可测量的指标而忽视患者的整体护理质量1。国际经验证实了这一风险：英国的Quality and Outcomes Framework在苏格兰因不利影响而被废除，但在英格兰仍在运行。相关研究显示该框架实施后患者更难看到同一医生1。
New Zealand's Health Minister Simeon Brown has announced a NZD 40 million funding initiative designed to reward general practice clinics that meet specific performance targets 1. The scheme targets several key health metrics: 90% full immunization rates for infants and young children, 80% cervical cancer screening completion among women, 25% smoking cessation support for smokers, and the establishment of online appointment booking portals 1.
However, academics have raised concerns about the potential drawbacks of implementing uniform performance targets across diverse communities. Clinics serving disadvantaged populations, such as Calder Centre in Auckland which works with high-risk transient groups, may face particular challenges in meeting standardized benchmarks 1. Regional disparities already exist—the Northland region reports an average immunization rate of 64%, compared to Canterbury's 88%—suggesting that a one-size-fits-all approach could inadvertently penalize practices operating in lower-performing areas 1. Researchers warn that such performance-based systems risk creating "tick-box medicine," where measurable indicators take precedence over comprehensive patient care quality 1. Evidence from the United Kingdom's Quality and Outcomes Framework demonstrates this risk: while Scotland abolished the program, England continues it, and studies show that QOF implementation was associated with patients finding it more difficult to see the same doctor consistently 1.
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