CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Comparative Study
Do physician-payment mechanisms affect hospital utilization? A study of Health Service Organizations in Ontario.
To determine whether payment of primary care physicians based on capitation, with an additional incentive payment for low hospital-utilization rates, resulted in lower hospital-utilization rates among patients of these physicians than among patients of physicians still paid on a fee-for-service basis. ⋯ Capitation payment, with an additional incentive payment to encourage low hospital-utilization rates, did not reduce hospital use. Factors other than the method of physician payment appear to be responsible for the variations in hospital utilization among practices.
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Like other countries in the Organization for Economic Cooperation and Development, Canada is attempting to contain the overall costs of health care by concentrating on the reform of health care delivery, not health care financing. Systems like Canada's, with predominantly public financing and mainly private delivery, have become increasingly popular around the world. Like other nations, Canada has implemented reforms to make the most of the health care dollars we do have. In this article, Susan MacPhee examines common approaches to health care reform.