Healthcare Quality by Specialists Under a Mixed Compensation System: An Empirical Analysis
利用加拿大魁北克省1999年改革，研究混合薪酬制度对专科医生服务质量的影响，发现改革增加了再住院和死亡风险。
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 rehospitalization and mortality after discharge.