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--...
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ftpubmed:oai:pubmedcentral.nih.gov:1059863 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 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059863 http://www.ncbi.nlm.nih.gov/pubmed/8120504 en eng http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059863 http://www.ncbi.nlm.nih.gov/pubmed/8120504 Research Article Text 1993 ftpubmed 2013-08-30T07:25:18Z 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 PubMed Central (PMC) Norway |
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Research Article Kristiansen, I S Holtedahl, K Effect of the remuneration system on the general practitioner's choice between surgery consultations and home visits. |
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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. |
publishDate |
1993 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059863 http://www.ncbi.nlm.nih.gov/pubmed/8120504 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Northern Norway |
genre_facet |
Northern Norway |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059863 http://www.ncbi.nlm.nih.gov/pubmed/8120504 |
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1766145599239880704 |