By the same authors

From the same journal

How should we pay doctors? A systematic review of salary payments and their effect on doctor behaviour

Research output: Contribution to journalLiterature reviewpeer-review

Author(s)

Department/unit(s)

Publication details

JournalQJM Monthly Journal of the Association of Physicians
DatePublished - Jan 1999
Issue number1
Volume92
Number of pages9
Pages (from-to)47-55
Original languageEnglish

Abstract

We reviewed the published and unpublished international literature to determine the influence of salaried payment on doctor behaviour. We systematically searched Medline, BIDS Embase, Econlit and BIDS ISI and the reference lists of located papers to identify relevant empirical studies comparing salaried doctors with those paid by alternative methods. Only studies which reported objective outcomes and measures of the behaviour of doctors paid by salary compared to an alternative method were included in the review. Twenty-three papers were identified as meeting the selection criteria. Only one of the studies in this review reported a proxy for health status, but none examined whether salaried doctors differentiated between patients on the basis of health needs. Therefore, we were unable to draw conclusions on the likely impact of salaried payment on efficiency and equity. However, the limited evidence in our review does suggest that payment by salaries is associated with the lowest use of tests, and referrals compared with FFS and capitation. Salary payment is also associated with lower numbers of procedures per patient, lower throughput of patients per doctor, longer consultations, more preventive care and different patterns of consultation compared with FFS payment.

    Research areas

  • FEE-FOR-SERVICE, GENERAL-PRACTITIONERS, FINANCIAL INCENTIVES, REMUNERATION SYSTEM, MEDICAL-CARE, PHYSICIANS, REIMBURSEMENT, PREVENTION, PREPAID, QUEBEC

Discover related content

Find related publications, people, projects, datasets and more using interactive charts.

View graph of relations