Behavioral Impact on Clinical Specialist Payment Method: A Systematic Review
Abstract
Background: With growing healthcare (HC) expenditures and limited funding, policymakers need to find new ways to provide healthcare that is affordable and fair. There are many methods for paying specialists, and the three basic payment methods include fee-for-service (FFS), capitation, and salary. This review focuses on identifying published articles related to the different methods used for paying specialists for their service and further highlights their advantages and disadvantages.
Methods: The research was designed and carried out in line with the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) checklist. Five databases were used in the literature search ie: Scopus, Web of Science, Ovid Medline, EBSCOhost, and PubMed in 2020. The search term used revolved around physician, payment method and specialist behavior.
Results: Databases were searched electronically using EndNote X9.2, wherein 588 related studies of literature were included. Meanwhile, it went down to 546 related studies after the title and abstract screening was conducted in order to eliminate duplicates. In total, 24 studies were then left to be reviewed in full text; finally, 12 studies were integrated into this analysis after a description of the entire text of the studies.
Conclusion: Payment methods can affect physician practice behaviors and the quality of healthcare. The combination of payment methods may, however, combine the benefits of simple payment methods. Where there is not adequate mixing of methods, bonus-for-performance programs may encourage the provision of targeted services. Thus, before a new medical policy is implemented, policymakers must define and empirically examine the positive and negative impacts.
2. Mossialos E, Djordjevic A, Osborn R, Sarnak D (2017). International Profiles of Health Care Systems: Australia. https://www.commonwealthfund.org/international-health-policy-center/countries/australia
3. Yip W, Powell-Jackson T, Chen W, et al (2014). Capitation Combined With Pay-For-Performance Improves Antibiotic Prescribing Practices In Rural China. Health Aff (Millwood), 33:502-510.
4. Siti N, Faiz D, Nik Azlan N (2020). Work Performance and Its Influencing Factors Among Support Staff in Hospital Mersing, Johor. Med Health, 15(2): 47-55.
5. Ran LM, Luo KJ, Wu YC, et al (2013). An analysis of China's physician salary payment system. J Huazhong Univ Sci Technolog Med Sci, 33(2):309-314.
6. Hassanipour S, Ghaem H, Arab-Zozani M, et al (2019). Comparison of artificial neural network and logistic regression models for prediction of outcomes in trauma patients: A systematic review and meta-analysis. Injury, 50:244-250.
7. Fahima Dossa, Andrea N Simpson, Rinku Sutradhar, et al (2019). Sex-Based Disparities in the Hourly Earnings of Surgeons in the Fee-for-Service System in Ontario, Canada. JAMA Surg, 154:1134-1142.
8. Quinn AE, Edwards A, Senior P, et al (2019). The association between payment model and specialist physicians’ selection of patients with diabetes: a descriptive study. CMAJ Open, 7:E109-E116.
9. Donofrio, Peter, Barkley, Gregory, Cohen, Bruce ea (2015). How neurologists are paid: Part 1: The Medicare payment system. Neurol Clin Pract, 5:397-404.
10. Esmaeili R, Hadian M, Rashidian A, et al (2016). The Experience of Risk-Adjusted Capitation Payment for Family Physicians in Iran: A Qualitative Study. Iran Red Crescent Med J, 18:e23782.
11. Judy Ying Chen, Ning Kang, Deborah Taira Juarez, et al (2010). Impact of a Pay-for-Performance Program on Low Performing Physicians. J Healthc Qual, 32:13-21.
12. Wharam J, Frank MB, BCh, BAO, MPH ea (2011). "Pay-for-performance" as a Quality Improvement Tool: Perceptions and Policy Recommendations of Physicians and Program Leaders. Qual Manag Health Care, 20(3):234-45.
13. Chen T-T, Lai M-S, Chung K-P (2016). Participating physician preferences regarding a pay-for-performance incentive design: a discrete choice experiment. Int J Qual Health Care, 28:40-46.
14. Yuan B, He L, Meng Q, Jia L (2017). Payment methods for outpatient care facilities. Cochrane Database Syst Rev, 3(3):CD011153.
15. Schmitz H (2013). Practice budgets and the patient mix of physicians–The effect of a remuneration system reform on health care utilisation. J Health Econ, 32(6):1240-9.
16. Wranik DW, Durier-Copp M (2010). Physician remuneration methods for family physicians in Canada: expected outcomes and lessons learned. Health Care Anal, 18:35-59.
17. Canadian Institute for Health Information (2007) Health Care in Canada 2007. (ed)^(eds), Canadian Institute for Health Information,, Ottawa, Ontario
18. Kantarevic J, Kralj B, Weinkauf D (2011). Enhanced fee-for-service model and physician productivity: evidence from Family Health Groups in Ontario. J Health Econ, 30:99-111.
19. Somé NH, Devlin RA, Mehta N, et al (2019). Production of physician services under fee‐for‐service and blended fee‐for‐service: Evidence from Ontario, Canada. Health Econ, 28:1418-1434.
20. Nguyen, Louis, Smith, Ann, Scully, Rebecca ea (2017). Provider-Induced Demand in the Treatment of Carotid Artery Stenosis: Variation in Treatment Decisions Between Private Sector Fee-for-Service vs Salary-Based Military Physicians. JAMA Surg, 152:565-572
21. Quentin W, Geissler A, Wittenbecher F, et al (2018). Paying hospital specialists: Experiences and lessons from eight high-income countries. Health Policy, 122:473-484.
22. Lin Y, Yin S, Huang J, Du LJJoEBM (2016). Impact of pay for performance on behavior of primary care physicians and patient outcomes. J Evid Based Med, 9(1):8-23.
23. Gosden T, Pedersen L, Torgerson D (1999). How should we pay doctors? A systematic review of salary payments and their effect on doctor behaviour. QJM, 92:47–55.
24. Feldhaus I, Mathauer I (2018). Effects of mixed provider payment systems and aligned cost sharing practices on expenditure growth management, efficiency, and equity: a structured review of the literature. BMC Health Serv Res, 18:996.
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Issue | Vol 51 No 7 (2022) | |
Section | Review Article(s) | |
DOI | https://doi.org/10.18502/ijph.v51i7.10081 | |
Keywords | ||
Payment methods Specialists behavior Fee-for-service Salary Capitation |
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