Recent trends in expenditures on physicians' services in Canada

Area of Science:

• Health Economics
• Health Services Research
• Canadian Healthcare System Analysis

Background:

• Understanding factors influencing physician payment growth is crucial for healthcare policy.
• Canada's fee-for-service payment model provides a case study for analyzing expenditure trends.

Purpose of the Study:

• To analyze trends in Canadian physician service expenditures from 1982 to 1987.
• To decompose payment growth into volume, price, and service mix components.
• To examine provincial variations in physician payment policies and their impact.

Main Methods:

• Analysis of national and provincial (Ontario, Quebec, Nova Scotia, British Columbia) fee-for-service physician payment data (1982-1987).
• Disaggregation of expenditure increases by service category, per physician, and per capita.
• Examination of three components of payment growth: number of services, physician service prices, and service mix.

Main Results:

• Physician payment growth was primarily driven by increases in service prices.
• Evidence suggests a shift towards higher-priced services per physician.
• Diagnostic/therapeutic and office services showed higher payment and volume growth than surgeries, with provincial variations observed.

Conclusions:

• Canada's physician payment system exhibits regional variations, indicating a lack of uniformity.
• Provincial payment restraint policies influenced the components of payment change.
• Price increases were the main driver of physician expenditure growth during the study period.