Patient attitudes toward physician financial incentives.
Arch Intern Med
; 161(10): 1313-7, 2001 May 28.
Article
en En
| MEDLINE
| ID: mdl-11371260
ABSTRACT
BACKGROUND:
Despite concern about the impact of financial incentives on physician behavior, little is known about patients' attitudes toward these incentives.OBJECTIVES:
To assess patient attitudes toward physician compensation models and to explore patient characteristics associated with these attitudes.METHODS:
We mailed a survey to 2000 adult patients in a large New England health maintenance organization. We asked about their trust in their primary care physician; discomfort with compensation models of salary with withhold (salary), fee-for-service with withhold, and group capitation (capitation).RESULTS:
One thousand one hundred twenty-five (56%) of the 2000 patients who responded expressed varying levels of discomfort with the proposed compensation models 16% for salary, 25% for fee-for-service with withhold, and 53% for capitation (P<.001). Patients who knew their primary care physician was paid through capitation did not report less trust in their primary care physician but still frequently expressed discomfort (46%) with capitation. Among all respondents, those who were younger, white, had better health, had a higher income, were more educated, and who lacked a very trusting relationship with a primary care physician were more likely to report discomfort with both capitation and fee-for-service with withhold. In multivariable analyses, discomfort with capitation was more common among white patients (odds ratio, 2.6; 95% confidence interval, 1.6-4.2), patients with incomes exceeding $20 000 (odds ratio, 3.7; 95% confidence interval, 2.3-6.1), and college-educated patients (odds ratio, 2.0; 95% confidence interval, 1.4-2.7).CONCLUSIONS:
Most patients were uncomfortable with 1 or more of the 3 common methods used to pay physicians. Discomfort was highest with capitation and was more likely among wealthier, well-educated, white patients. With capitation increasing nationally, patients' concerns should be considered in the design of compensation agreements.Palabras clave
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pacientes
/
Relaciones Médico-Paciente
/
Pautas de la Práctica en Medicina
/
Capitación
/
Planes de Incentivos para los Médicos
/
Actitud
/
Sistemas Prepagos de Salud
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Arch Intern Med
Año:
2001
Tipo del documento:
Article
País de afiliación:
Estados Unidos