Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Changing remuneration systems: effects on activity in general practice.

A Krasnik1, P P Groenewegen, P A Pedersen

  • 1Institute of Social Medicine, University of Copenhagen, Panum Institute, Denmark.

BMJ (Clinical Research Ed.)
|June 30, 1990
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Do Danish medical students feel prepared to deliver healthcare to patients with backgrounds different from their own? A cross-sectional survey.

BMC medical education·2024
Same author

Practice variation in home care nursing: mapping potential explanations through a scoping review of the literature.

Research in health services & regions·2024
Same author

Social concordance and patient reported experiences in countries with different gender equality: a multinational survey.

BMC primary care·2024
Same author

Challenges and Opportunities for Implementing Diversity Competence in a Medical Education Curriculum: A Qualitative Study of Perceptions Among Students and Teachers.

Journal of medical education and curricular development·2024
Same author

Trends in social inequality in loneliness among adolescents 1991-2014.

Journal of public health (Oxford, England)·2018
Same author

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries.

BMC health services research·2018
Same journal

Doctors are fighting to protect children from mouldy homes after death of Awaab Ishak.

BMJ (Clinical research ed.)·2026
Same journal

Delayed discharges: Annual cost rises to almost £2.7bn in past year.

BMJ (Clinical research ed.)·2026
Same journal

The UK's social media ban is a gamble in the face of uncertainty.

BMJ (Clinical research ed.)·2026
Same journal

Wegovy weight loss pill now available to UK patients-how will it affect doctors?

BMJ (Clinical research ed.)·2026
Same journal

Endometriosis: "Game changing" new tests may speed up diagnosis in primary care.

BMJ (Clinical research ed.)·2026
Same journal

Consultants vote for industrial action in England.

BMJ (Clinical research ed.)·2026
See all related articles

A shift to a mixed fee-for-service and capitation payment system for general practitioners (GPs) increased service provision and reduced referrals. GPs appear to adjust to a target income rather than maximizing earnings.

Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Health Economics

Background:

  • General practitioner (GP) remuneration models significantly influence healthcare delivery and resource utilization.
  • Understanding the impact of payment system changes is crucial for optimizing primary care services and costs.
  • The transition from capitation to mixed systems warrants investigation into its effects on GP practice patterns.

Purpose of the Study:

  • To evaluate the impact of transitioning from a capitation-based to a mixed fee-for-service (FFS) and capitation remuneration system on general practitioners' activities.
  • To analyze changes in consultation rates, service provision, and referral patterns following the remuneration system change.

Main Methods:

  • A follow-up study design was employed, collecting data from general practitioners' contact sheets before and after the remuneration change.

Related Experiment Videos

  • Data were gathered from GPs in Copenhagen city (index group) and Copenhagen county (control group) over specified periods in 1987 and 1988.
  • Key outcome measures included the number of consultations (face-to-face and telephone), prescription renewals, diagnostic/curative services, and specialist/hospital referrals per 1000 patients.

    • Main Results:

    • Total patient contact rates increased significantly post-remuneration change in the index group compared to pre-change and control groups, though rates declined within a year.
    • Rates of diagnostic and curative services, which attracted additional remuneration, rose significantly after the change in the index group.
    • Referral rates to specialist and hospital care decreased in the index group following the introduction of the mixed payment system.

    Conclusions:

    • Implementing a partial fee-for-service system incentivized general practitioners to increase service provision, leading to a reduction in referral rates.
    • The findings suggest that general practitioners may adjust their practice patterns based on a 'target income' concept rather than solely aiming for income maximization.
    • Changes in remuneration systems can effectively modify GP behavior, impacting service delivery and healthcare system efficiency.