Payment mechanisms for family physicians

Added June 2, 2020

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.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.