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

Author:

Damien Echevin, Bernard Fortin, Aristide Houndetoungan

Keyword:

Economics, General Economics, General Economics (econ.GN)

journal:

date:

2024-02-06 00:00:00

Abstract

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.

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