PMID: 8603321Mar 1, 1996Paper

Do physician-payment mechanisms affect hospital utilization? A study of Health Service Organizations in Ontario

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
B HutchisonF Stratford-Devai

Abstract

To determine whether payment of primary care physicians based on capitation, with an additional incentive payment for low hospital-utilization rates, resulted in lower hospital-utilization rates among patients of these physicians than among patients of physicians still paid on a fee-for-service basis. Retrospective cohort study. Capitation-based and fee-for-service primary care practices in Ontario. Thirty-nine physicians whose method of payment was converted from fee-for-service to capitation during the period from June 1985 to January 1989 and 7 physicians who remained in fee-for-service practice, two of whom were matched with one physician in capitation-based practice on the basis of practice location, type of practice (academic v. community), hours of practice (part-time v. full-time), years since graduation, physician group size, practice size (number of patients), type of group (primary care v. multispecialty), sex, certification in family medicine, country of graduation (Canada v. other) and age. One physician in capitation-based practice was matched with only one physician in fee-for-service practice. Annual hospital-utilization rates (hospital separations or hospital days per 1000 patients in each practice) for the phy...Continue Reading

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