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. 2013 Nov;9(2):30-5.

Fee increases and target income hypothesis: data from Quebec on physicians' compensation and service volumes

Damien Contandriopoulos  1 , Mélanie Perroux  2
Affiliations

Fee increases and target income hypothesis: data from Quebec on physicians' compensation and service volumes

Damien Contandriopoulos et al. Healthc Policy. 2013 Nov.

Abstract
in English, French

Recent years have witnessed important public investments in physicians' compensation across Canada. The current paper uses data from Quebec to assess the impact of those investments on the volumes of services provided to the population. While total physician compensation costs, average physician compensation and average unit cost per service all rose extremely fast, the total number of services, number of services per capita and average number of services per physician either stagnated or declined. This pattern is compatible with the economic target income hypothesis and raises important policy questions.

Ces dernières années, d'importants investissements publics dans la rémunération des médecins ont été consentis partout au Canada. Cet article utilise les données du Québec pour évaluer l'impact de ces investissements sur le volume de services fourni à la population. Alors que les dépenses totales liées à la rémunération des médecins, la rémunération moyenne par médecin et le coût unitaire moyen par service ont tous trois connu une hausse très rapide, la quantité totale de services, le nombre de services par personne et le nombre moyen de services par médecin ont soit stagné soit décliné. Ces observations sont conformes aux comportements attendus selon l'hypothèse économique de la recherche d'un revenu cible de la part des médecins ce qui soulève d'importantes questions à propos des politiques publiques.

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Figures

FIGURE 1.
FIGURE 1.
Family physicians: Evolution of practice and costs Source: Based on data from RAMQ 2012.
FIGURE 2.
FIGURE 2.
Specialist physicians: Evolution of practice and costs Source: Based on data from RAMQ 2012.
See this image and copyright information in PMC

References

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    1. Canadian Institute for Health Information (CIHI). 2013. National Physician Database, 2011–2012 Data Release. Retrieved October 29, 2013. <https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC2368>.
    1. Commissaire à la santé et au bien-être du Québec (CSBE). 2013. Perceptions et expériences des médecins de première ligne: Le Québec comparé. Résultats de l'Enquête internationale sur les politiques de santé du commonwealth fund de 2012. Quebec: Author.
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