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CJEM. 2018 Mar;20(2):183-190. doi: 10.1017/cem.2018.10.

Impact of physician payment mechanism on emergency department operational performance.

Author information

1
*Department of Emergency Medicine, University of Calgary,Calgary,AB.
2
†Department of Emergency Medicine, St. Paul's Hospital,Vancouver,BC.
3
‡Department of Emergency Medicine, Vancouver General Hospital,Vancouver,BC.
4
§University of British Columbia School for Population and Public Health,Vancouver,BC.

Abstract

CLINICIAN'S CAPSULE What is known about the topic? Fee-for-service compensation may motivate physicians to see more patients and improve throughput, or drive excessive testing and referral behaviour that undermine emergency performance. What did this study ask? Does fee-for-service payment reduce emergency wait times, length of stay, and left without being seen rates? What did this study find? We observed an unsustained 24% reduction in time to physician, but no change in length of stay or left without being seen rates. Why does this study matter to clinicians? Fee-for-service compensation may have transient motivational effect but is unlikely to generate system-level improvement.

KEYWORDS:

access; efficiency; physician compensation; wait time; emergency department

PMID:
29534785
DOI:
10.1017/cem.2018.10

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