Behavioral Impact on Clinical Specialist Payment Method:  A Systematic Review

Nor Izyani  Bahari; Mazni  Baharom; Syahidatun Najwa   Abu Zahid; Faiz  Daud

doi:10.18502/ijph.v51i7.10081

Nor Izyani Bahari Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Mazni Baharom Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Syahidatun Najwa Abu Zahid Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Faiz Daud Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

DOI: https://doi.org/10.18502/ijph.v51i7.10081

Keywords: Payment methods; Specialists behavior; Fee-for-service; Salary; Capitation

Abstract

Background: With growing healthcare (HC) expenditures and limited funding, policymakers need to find new ways to provide healthcare that is affordable and fair. There are many methods for paying specialists, and the three basic payment methods include fee-for-service (FFS), capitation, and salary. This review focuses on identifying published articles related to the different methods used for paying specialists for their service and further highlights their advantages and disadvantages.

Methods: The research was designed and carried out in line with the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) checklist. Five databases were used in the literature search ie: Scopus, Web of Science, Ovid Medline, EBSCOhost, and PubMed in 2020. The search term used revolved around physician, payment method and specialist behavior.

Results: Databases were searched electronically using EndNote X9.2, wherein 588 related studies of literature were included. Meanwhile, it went down to 546 related studies after the title and abstract screening was conducted in order to eliminate duplicates. In total, 24 studies were then left to be reviewed in full text; finally, 12 studies were integrated into this analysis after a description of the entire text of the studies.

Conclusion: Payment methods can affect physician practice behaviors and the quality of healthcare. The combination of payment methods may, however, combine the benefits of simple payment methods. Where there is not adequate mixing of methods, bonus-for-performance programs may encourage the provision of targeted services. Thus, before a new medical policy is implemented, policymakers must define and empirically examine the positive and negative impacts.