A scoping review on the behavioral impact of physician payment methods

Corresponding author: Yao Qiang, yaoqianghero@126.com

DOI: 10.12201/bmr.202505.00016

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  Abstract: Objective： To systematically analyze the impact of various physician payment methods on medical service delivery behavior and outcomes. Methods: Based on the scoping review method, documents related to “physician”, “compensation”, “payment method”, and “physician behavior” were retrieved from Web of Science, CNKI, VIP, and WanFang databases, and finally included based on scientific screening standards and process. Results: Fee-for-service encourages physicians to deliver an adequate volume of services but is susceptible to overtreatment; salary and capitation assist in controlling costs but can lead to insufficient service provision; the advantages of DRG/DIP in the quantity and quality of medical services weaken as the patients condition worsens. Mixed payment methods can effectively balance the quantity and cost of medical services, while pay-for-performance is generally outstanding in improving quality. Conclusion: It is difficult for a single payment method to achieve the optimization of medical service delivery behavior and outcomes. A mixed payment system that integrates multiple payment methods with quality incentives must be established urgently. At the same time, it is recommended to deepen the reform of the mechanism for converting medical insurance balance into physician compensation, fully implement the allocation autonomy of public hospitals, and accelerate the establishment of a mixed physician payment method that is coordinated with medical insurance payment and performance appraisal.

  Key words: Physician Compensation; Payment methods; Incentives; Physician Behavior; Scoping Review

  Submit time: 19 May 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2025-04-03	bmr.202505.00016V1	Download

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