Although capitation has become an increasingly common method of payment for heath care, little is known about changes in physician satisfaction as they become more experienced working in a capitated environment.
We surveyed the members of a physician hospital organization at an urban teaching hospital in the summers of 1996 and 1997.
In 1996, fully capitated contracts covered<5% of patients under 65 years of age, but that figure increased to nearly 25% by 1997.
We assessed physicians'satisfaction with their practice, compared satisfaction under fee-for-service and capitated payment, and evaluated ethical issues related to capitation.
In 1996, we surveyed 587 physicians with direct patient care responsibilities, of whom 62% responded ; 51% of 520 physicians responded in 1997.
Overall satisfaction was 57% in 1996 and 71% in 1997.
Among physicians who responded in both years, overall satisfaction was unchanged, but increases in satisfaction were noted for patient load (an increase of 0.5 points on a five-point scale, P<0.01), time to discuss patient needs (an increase of 0.3 points, P<0.01), and helpfulness of care coordination (an increase of 0.5 points, P=0.02).
In a direct comparison between fee-for-service and capitation, physicians were more satisfied with both methods of payment in 1997 than they were in 1996, but they were much more satisfied with fee-for-service in both years. (...)
Mots-clés Pascal : Soin santé primaire, Rémunération, Médecin, Etats Unis, Amérique du Nord, Amérique, Expérience professionnelle, Satisfaction professionnelle, Evaluation, Questionnaire, Capitation
Mots-clés Pascal anglais : Primary health care, Remuneration, Physician, United States, North America, America, Professional experience, Job satisfaction, Evaluation, Questionnaire
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0398247
Code Inist : 002B30A05. Création : 22/03/2000.