Please use this identifier to cite or link to this item: http://hdl.handle.net/1822/60222

TitleHow does the type of remuneration affect physician behaviour? Fixed salary versus fee-for-service
Author(s)Brekke, Kurt R.
Holmås, Tor Helge
Monstad, Karin
Straume, Odd Rune
KeywordsPhysicians
Primary care
Fixed salary
Fee-for-service
Issue date2018
PublisherUniversidade do Minho. Núcleo de Investigação em Políticas Económicas (NIPE)
JournalNIPE Working Paper
Abstract(s)We analyse the effects of two different types of physician remuneration - fee-for-service and fixed salary on the treatment decisions of general practitioners (GPs) and on patients´ health outcomes. Using rich Norwegian register data during the period 2009-2013,we focus on GP locums working in a succession of temporary positions, which allows us to observe the same GPs working under different remuneration schemes within a relatively short period of time. We find that GPs respond strongly and consistently to changes in remuneration type. Compared with fixed salary, GP payment by fee-for-service leads to an increase in the supply of consultations and a higher provision of medical services (along several dimensions) per consultation. This has also signiffcant implications for patients´health outcomes. The probability of experiencing an emergency admission to hospital shortly after a GP consultation is close to 20 percent lower if the GP is paid by fee-for-service instead of fixed salary. Overall, our analysis suggests that fixed-salary remuneration leads to underprovision of primary care.
TypeWorking paper
URIhttp://hdl.handle.net/1822/60222
Publisher versionhttps://www.eeg.uminho.pt/pt/investigar/nipe/Paginas/publicacoes.aspx
Peer-Reviewedno
AccessOpen access
Appears in Collections:NIPE - Documentos de Trabalho

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