| Autor: |
S B, Ransom, S G, McNeeley, M L, Kruger, G, Doot, D B, Cotton |
| Rok vydání: |
1996 |
| Předmět: |
|
| Zdroj: |
Obstetrics & Gynecology. 87:707-710 |
| ISSN: |
0029-7844 |
| DOI: |
10.1016/0029-7844(96)00008-7 |
| Popis: |
To evaluate the variations in physician behavior leading to performance of gynecologic surgical procedures related to fee-for-service and capitation reimbursement systems.This study compared the physician practice utilization of surgical services for fee-for-service and capitated contract reimbursement systems within a gynecology clinic. Attending gynecologists were reimbursed on a fee-for-service basis for all surgical services performed during a 6-month interval; subsequently, the same physicians were reimbursed on a capitated basis for 6 months and received a fixed payment for the clinical and surgical services provided.Three thousand seven hundred eighty consecutive outpatient gynecology visits were evaluated at the university gynecology clinic during 1994. We found a 15% overall decrease in the number of surgical procedures that were performed during the capitated reimbursement period compared with the fee-for-service time interval. The procedure most responsible for the reduction of surgical services was elective sterilization by laparoscopy, which underwent a statistically significant decrease (P.01).The remuneration system in our review seemed to affect physician decision making for only the most elective procedures, whereas physicians maintained similar practice patterns for more severe conditions. Fee-for-service seems to encourage, whereas capitation seems to discourage, gynecologist from performing elective procedures. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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