Healthcare Quality by Specialists under a Mixed Compensation System: an Empirical Analysis

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Hauptverfasser: Echevin, Damien, Fortin, Bernard, Houndetoungan, Aristide
Format: Preprint
Veröffentlicht: 2024
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author Echevin, Damien
Fortin, Bernard
Houndetoungan, Aristide
author_facet Echevin, Damien
Fortin, Bernard
Houndetoungan, Aristide
contents We analyze the effects of a mixed compensation (MC) scheme for specialists on the quality of their healthcare services. We exploit a reform implemented in Quebec (Canada) in 1999. The government introduced a payment mechanism combining a per diem with a reduced fee per clinical service. Using a large patient/physician panel dataset, we estimate a multi-state multi-spell hazard model analogous to a difference-in-differences approach. We compute quality indicators from our model. Our results suggest that the reform reduced the quality of MC specialist services measured by the risk of re-hospitalization and mortality after discharge. These effects vary across specialties.
format Preprint
id arxiv_https___arxiv_org_abs_2402_04472
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Healthcare Quality by Specialists under a Mixed Compensation System: an Empirical Analysis
Echevin, Damien
Fortin, Bernard
Houndetoungan, Aristide
General Economics
Economics
We analyze the effects of a mixed compensation (MC) scheme for specialists on the quality of their healthcare services. We exploit a reform implemented in Quebec (Canada) in 1999. The government introduced a payment mechanism combining a per diem with a reduced fee per clinical service. Using a large patient/physician panel dataset, we estimate a multi-state multi-spell hazard model analogous to a difference-in-differences approach. We compute quality indicators from our model. Our results suggest that the reform reduced the quality of MC specialist services measured by the risk of re-hospitalization and mortality after discharge. These effects vary across specialties.
title Healthcare Quality by Specialists under a Mixed Compensation System: an Empirical Analysis
topic General Economics
Economics
url https://arxiv.org/abs/2402.04472