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Family practitioners' remuneration and patterns of care — does social class matter?

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  • Norbert Donner-Banzhoff
  • Lothar Kreienbrock
  • Marko Katic

Abstract

L'objectif de l'étude est d'èvaluer si les caracteristiques des soins médicaux et/ou leur résultats, selon qu'ils soient donnés dans un système de prise en chargé systématique préalable ou de paiement à l'acte, different en fonction du niveau social des patients. Certains auteurs ont suggéré ce type d'influence au sujet de l'experience d'assurance maladie RAND (RAND HIE). Nous avons réalisé une étude transversale chez des médecins généralistes en Allemagne (paiement à l'acte) et au Royaume Uni (prise en charge préalable dans un système de liste administrative des sujets). 778 patients de plus de 18 ans ont été inclus. L'interrogatoire des patients, les questionnaires remplis d'une part par le patient d'autre part par le médecin, la revue des dossiers cliniques, et la prise de la tension artérielle (TA) ont fourni les informations sur les indicateurs de soins, liés principalement à la prévention des affections cardiovasculaires. Les interactions potentielles entre le niveau social et le système de paiement ont été étudiées par des modèles de regression soit linéaire soit logistique avec ces indicateurs comme variables dépendantes. Le niveau social, comme facteur principal, était lié à la TA diastolique, à la répétition de la prise de la TA, et au nombre des mesures autres que le traitement médicamenteux destinées à baisser la TA. Cette étude n'a pas montré une interaction significative entre le niveau social des patients et le système de rémunération des médecins. Nous n'avons pas pu confirmé les hypothèses suggerées par les investigateurs de l'étude RAND HIE. Copyright Birkhäuser Verlag 1998

Suggested Citation

  • Norbert Donner-Banzhoff & Lothar Kreienbrock & Marko Katic, 1998. "Family practitioners' remuneration and patterns of care — does social class matter?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 43(2), pages 73-79, March.
    • Handle: RePEc:spr:ijphth:v:43:y:1998:i:2:p:73-79
    DOI: 10.1007/BF01359227
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    References listed on IDEAS

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    1. Lahelma, Eero & Valkonen, Tapani, 1990. "Health and social inequities in Finland and elsewhere," Social Science & Medicine, Elsevier, vol. 31(3), pages 257-265, January.
    2. Mackenbach, Johan P. & Stronks, Karien & Kunst, Anton E., 1989. "The contribution of medical care to inequalities in health: Differences between socio-economic groups in decline of mortality from conditions amenable to medical intervention," Social Science & Medicine, Elsevier, vol. 29(3), pages 369-376, January.
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