Payment mechanisms for family physicians
Citation: Vahidi RG, Mojahed F, Jafarabadi MA, et al. A systematic review of the effect of payment mechanisms on family physicians service provision and referral rate behavior. Journal of Pioneering Medical Sciences 2013; 3(1):54-60
What is this? The COVID-19 pandemic is placing a strain on healthcare systems and resources. Existing research on payment mechanisms for primary health care might provide useful information for policy makers.
In this systematic review, the authors searched for studies that assessed the effect of different payment models on physician behavior in primary care. They restricted their searches to articles published in English or Persian between 1985 and 2011. They included 8 cohort studies, 2 controlled before-and-after studies, and 1 comparative study of another design. The studies were from
Canada (3 studies), Denmark (1), England (1), Norway (3), South Africa (1), USA (1) and Uruguay (1). The studies compared fee-for-service versus salary (6 studies), fee-for-service versus capitation (4), and salary versus capitation/fee-for-service (1).
What was found: In the studies of fee-for-service versus salary, fee-for-service increased the consultation rate and lowered the hospital referral rate.
In the studies of fee-for-service versus capitation, capitation payment decreased the number of provided services.
The effects of different payment mechanisms on physician behavior in low- and middle-income countries are uncertain.
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