Comparative aspects of medical practice. Organizational setting and financial arrangements in four delivery systems

Effects of financial arrangement and organizational setting on the socioeconomic aspects of four health care delivery systems are assessed. Analysis of variance tests are used to analyze differences between group and solo fee-for-service practices, prepaid group practices, and independent practice associations. Solo fee-for-service physicians tended to be older, to be non-board-certified, to prefer autonomy over earnings, and to have more patient visits, longer hours, and shorter waits for an appointment. Prepaid group physicians tended to be younger, to prefer a specific practice location and predictable schedule, to have lower incomes and expenses coupled with fewer patient visits, shorter work weeks, and longer patient waiting times. If current trends continue, new physicians may develop practice arrangements combining elements of fee-for-service and prepayment.