Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits.
OBJECTIVE--To assess the influence of the remuneration system, municipality, doctor, and patient characteristics on general practitioners' choices between surgery and home visits. DESIGN--Prospective registration of patient contacts during one week for 116 general practitioners (GPs). SETTING--...
Published in: | Journal of Epidemiology & Community Health |
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BMJ Publishing Group Ltd
1993
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fthighwire:oai:open-archive.highwire.org:jech:47/6/481 2023-05-15T17:43:30+02:00 Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. Kristiansen, I S Holtedahl, K 1993-12-01 00:00:00.0 text/html http://jech.bmj.com/cgi/content/short/47/6/481 https://doi.org/10.1136/jech.47.6.481 en eng BMJ Publishing Group Ltd http://jech.bmj.com/cgi/content/short/47/6/481 http://dx.doi.org/10.1136/jech.47.6.481 Copyright (C) 1993, BMJ Publishing Group Ltd Research Article TEXT 1993 fthighwire https://doi.org/10.1136/jech.47.6.481 2013-05-28T04:45:59Z OBJECTIVE--To assess the influence of the remuneration system, municipality, doctor, and patient characteristics on general practitioners' choices between surgery and home visits. DESIGN--Prospective registration of patient contacts during one week for 116 general practitioners (GPs). SETTING--General practice in rural areas of northern Norway. MAIN OUTCOME MEASURE--Type of GP visit (surgery v home visit). RESULTS--The estimated home visit rate was 0.14 per person per year. About 7% (range 0-39%) of consultations were home visits. Using multilevel analysis it was found that doctors paid on a "fee for service" basis tended to choose home visits more often than salaried doctors (adjusted odds ratio 1.90, 99% confidence interval 0.98, 3.69), but this was statistically significant for "scheduled" visits only (adjusted OR 4.50, 99% CI 1.67, 12.08). Patients who were older, male, and who were living in areas well served by doctors were more likely to receive home visits. CONCLUSION--In the choice between home visits and surgery consultations, doctors seem to be influenced by the nature of the remuneration when the patient's problem is not acute. Although home visiting is a function of tradition, culture, and organisational characteristics, the study indicates that financial incentives may be used to change behaviour and encourage home visiting. Text Northern Norway HighWire Press (Stanford University) Norway Journal of Epidemiology & Community Health 47 6 481 484 |
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HighWire Press (Stanford University) |
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fthighwire |
language |
English |
topic |
Research Article |
spellingShingle |
Research Article Kristiansen, I S Holtedahl, K Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
topic_facet |
Research Article |
description |
OBJECTIVE--To assess the influence of the remuneration system, municipality, doctor, and patient characteristics on general practitioners' choices between surgery and home visits. DESIGN--Prospective registration of patient contacts during one week for 116 general practitioners (GPs). SETTING--General practice in rural areas of northern Norway. MAIN OUTCOME MEASURE--Type of GP visit (surgery v home visit). RESULTS--The estimated home visit rate was 0.14 per person per year. About 7% (range 0-39%) of consultations were home visits. Using multilevel analysis it was found that doctors paid on a "fee for service" basis tended to choose home visits more often than salaried doctors (adjusted odds ratio 1.90, 99% confidence interval 0.98, 3.69), but this was statistically significant for "scheduled" visits only (adjusted OR 4.50, 99% CI 1.67, 12.08). Patients who were older, male, and who were living in areas well served by doctors were more likely to receive home visits. CONCLUSION--In the choice between home visits and surgery consultations, doctors seem to be influenced by the nature of the remuneration when the patient's problem is not acute. Although home visiting is a function of tradition, culture, and organisational characteristics, the study indicates that financial incentives may be used to change behaviour and encourage home visiting. |
format |
Text |
author |
Kristiansen, I S Holtedahl, K |
author_facet |
Kristiansen, I S Holtedahl, K |
author_sort |
Kristiansen, I S |
title |
Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
title_short |
Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
title_full |
Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
title_fullStr |
Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
title_full_unstemmed |
Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
title_sort |
effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
publisher |
BMJ Publishing Group Ltd |
publishDate |
1993 |
url |
http://jech.bmj.com/cgi/content/short/47/6/481 https://doi.org/10.1136/jech.47.6.481 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Northern Norway |
genre_facet |
Northern Norway |
op_relation |
http://jech.bmj.com/cgi/content/short/47/6/481 http://dx.doi.org/10.1136/jech.47.6.481 |
op_rights |
Copyright (C) 1993, BMJ Publishing Group Ltd |
op_doi |
https://doi.org/10.1136/jech.47.6.481 |
container_title |
Journal of Epidemiology & Community Health |
container_volume |
47 |
container_issue |
6 |
container_start_page |
481 |
op_container_end_page |
484 |
_version_ |
1766145591130193920 |