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

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  • Damien Echevin
  • Bernard Fortin
  • Aristide Houndetoungan

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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  • Damien Echevin & Bernard Fortin & Aristide Houndetoungan, 2024. "Healthcare Quality by Specialists under a Mixed Compensation System: an Empirical Analysis," Papers 2402.04472, arXiv.org.
    • Handle: RePEc:arx:papers:2402.04472
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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C41 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Duration Analysis; Optimal Timing Strategies

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