Does the method of payment affect anaesthetic practice? An evaluation of an alternate payment plan

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
P G Duncan, M Ballantyne

Abstract

To test the null hypothesis that the method of physician payment does not influence the practice of anaesthesia. Retrospective cohort study of anaesthetists before (Jan-June, 1994) and after (Jan-June, 1995) departure from fee-for-service practice into an alternate funding arrangement (AFP). Another group of physicians was studied as a concurrent control. Case numbers, induction times, cancellation rates, and operating hours for the department, recorded by third parties, were compared before and after AFP implementation. Using index procedures, details of individual patient decisions made by anaesthetists were compared for the two study periods, and between subscribing and non-subscribing physicians. Implementation of AFP resulted in a modest reduction in case numbers (7.2%) offset by an increase (5.7%) in the average case duration. Net change in time dedicated to clinical service (2% per physician) is inconsequential to the academic mission of the department. There was no change in cancellation rate and the use of invasive monitors was unchanged. An increase in the use of regional anaesthesia occurred but, since a similar increase occurred in the practice of those still on fee-for-service, it cannot be ascribed to the AFP. Wit...Continue Reading

References

Oct 1, 1990·Anesthesiology·D A RevickiJ M Weschler
Jun 15, 1990·Annals of Internal Medicine·A L Hillman
Dec 21, 1995·The New England Journal of Medicine·M R GoldR Berenson
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Citations

Feb 1, 1999·Healthcare Management Forum·M Anderson, J Cosby
Jun 20, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Gordon H MorewoodJohn P Gaughan
Oct 20, 2006·Pediatric Annals·Narlito V Cruz, Sami L Bahna
Sep 1, 2007·Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India·Sudhakar VaidyaV K Sharma
Apr 11, 2015·Stroke; a Journal of Cerebral Circulation·David Bruce MatcharYuan Tian
Jul 28, 2001·Anesthesia and Analgesia·J R FeinerR F Hickey
Nov 9, 2019·JAMA Network Open·Samaya J AnumuduKevin F Erickson

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