Research on the impact of physician's compensation payment methods on medical service behavior:A scoping review
10.3969/j.issn.1674-2982.2025.04.004
- VernacularTitle:医生薪酬支付方式对医疗服务行为的影响研究
- Author:
Qiang YAO
1
;
Yue-fang JIAO
;
Xiao-dan ZHANG
;
Ya-qi RAO
;
Hui-ling ZHENG
;
Mian XIA
Author Information
1. 武汉大学政治与公共管理学院 湖北 武汉 430072;武汉大学社会保障研究中心 湖北 武汉 430072;国家医保研究院华科基地 湖北 武汉 430030
- Publication Type:Journal Article
- Keywords:
Physician's compensation;
Payment methods;
Incentive mechanism;
Medical service behavior;
Scoping review
- From:
Chinese Journal of Health Policy
2025;18(4):25-35
- CountryChina
- Language:Chinese
-
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,2 255 documents related to"physician","compensation","payment method",and"physician behavior"were retrieved from Web of Science,CNKI,VIP,and WanFang databases,and finally 70 studies were 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 patient's 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.Conclusions: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.
