Performance-based reimbursement in health care. Consequences for physicians' cost awareness and work environment.

Full Abstract

BACKGROUND:
The funding and structure of health care is currently undergoing major changes. The impact of such changes on professional behaviour and working conditions have not been widely studied in Europe. The two aims of this study were to prospectively assess the impact of performance-based reimbursement on physicians' attitudes and self-assessed professional behaviour, related to cost awareness, as well as their working conditions.

METHOD:
Physicians in Stockholm County Council (with a performance-based reimbursement system) and physicians in eleven Swedish councils without performance-based reimbursement were examined simultaneously in 1994. This was a cross-sectional questionnaire study.

RESULT:
The results show a heightened cost awareness among physicians in Stockholm but also greater discontent with working condition factors such as decision latitude, job satisfaction and personal well-being.

CONCLUSION:
These results suggest that in order to counteract physicians discontent as a result of altered structure and increased focus on performance-based reimbursement, the autonomy and influence of physicians over the work processes need to be considered.

Learn Faster Today Improve your study skills

Author information

Author/s: Forsberg, Ewa (E); Axelsson, Runo (R); Arnetz, Bengt (B);

Affiliation: Centre for Development of Health Services, Box 4402, S-102 68 Stockholm, Sweden. ewa.forsberg(-atsign-)smd.sll.se

Journal and publication information

Publication Type: Journal Article

Journal: European journal of public health (Eur J Public Health), published in England. (Language: eng)

Reference: 2002-Mar; vol 12 (issue 1) : pp 44-50

Dates: Created 2002/04/23; Completed 2002/11/26; Revised 2004/11/17;

PMID: 11968520, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Attitude of Health Personnel
Awareness - physiology
Cross-Sectional Studies
Decision Making - physiology
Delivery of Health Care - economics
Female
Health Care Costs
Humans

Humans
Job Satisfaction
Male
Middle Aged
Physicians - economics
Questionnaires
Reimbursement, Incentive - economics
Sweden
Workload - statistics & numerical data

These are the highest related articles currently in the database:

See 100+ related articles.