Performance-based payment systems for general practitioners and specialists in selected countries: A comparative study

Eghbali, Mohammad Ebrahim, Pourasghari, Hamid, Abolghasem Gorji, Hasan, Martini, Mariano, Arabloo, Jalal, Behzadifar, Masoud and Aryankhesal, Aidin (2025) Performance-based payment systems for general practitioners and specialists in selected countries: A comparative study. Journal of Preventive Medicine and Hygiene, 66 (1). E114-E125. ISSN 1121-2233

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Abstract

Background. Due to the growing increase in the needs of health systems in the field of financial and human resources management, performance-based payment has been the subject of attention by health and welfare policymakers. This study aimed to compare the components of performance-based payment in selected countries. Methods. This comparative study was conducted in 2021. The selection of countries was based on three measures: the type of health insurance system, the development of the performance-based payment system, and the state of economic development of the countries. The findings were organized using comparative analysis tables. The general framework of performance-based payment systems, including goals, activities and actions, people involved in the program, and the way of encouraging and punishing, was used for analysis. Results. The findings of the study showed that in most of the programs, aspect of clinical quality has the highest weight. Other dimensions include patient experience and satisfaction, physician financial performance, and patients’ access to services. In most programs, various risk adjustment methods such as exception reporting, combined payments, payment according to demographic characteristics, were used to reduce provider risk, and clinical service providers were actively involved in the program design progressive. Conclusions. Despite the widespread use of performance-based payment programs in most countries, these programs face limitations and shortcomings. By linking incentives to individual, team, and organizational performance, a performance-based payment program can improve teamwork, and create integrated health care.

Item Type: Article
Additional Information: This study was part of a PhD thesis supported by the School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran (IUMS/SHMIS-98-3-37-16007).
Uncontrolled Keywords: health policy,pay for performance,performance evaluation indicators,quality-based payment,value-based payment,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 30 Jun 2025 12:30
Last Modified: 30 Jun 2025 13:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/99781
DOI: 10.15167/2421-4248/jpmh2025.66.1.3511

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