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Physician payment schemes and physician productivity: Analysis of Turkish healthcare reforms

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  • Erus, Burcay
  • Hatipoglu, Ozan

Abstract

Following healthcare reforms in Turkey, inpatient and outpatient care provided in public hospitals more than doubled from 2003 to 2006. An important component of the reforms has been a shift from a salary based physician compensation scheme to one where fee-for-service component is dominant. The change did not only incentivize physicians to provide a higher volume of services but also encouraged them to practice full-time, rather than dual-time, in public hospitals. Lacking figures on full-time equivalent figures at hospital level, earlier research used head-counts for physician workforce and found technological change and scale economies to be important determinants. We employ data envelopment analysis and find that, under plausible scenarios regarding the number of dual vs full-time physician numbers, most of the change in hospital services may be explained only by the shift to full-time practice. Our estimations find the change in technology and scale economies to play a relatively minor role.

Suggested Citation

  • Erus, Burcay & Hatipoglu, Ozan, 2017. "Physician payment schemes and physician productivity: Analysis of Turkish healthcare reforms," Health Policy, Elsevier, vol. 121(5), pages 553-557.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:5:p:553-557
    DOI: 10.1016/j.healthpol.2017.02.012
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    References listed on IDEAS

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    Cited by:

    1. Matthias Klumpp & Dominic Loske & Silvio Bicciato, 2022. "COVID-19 health policy evaluation: integrating health and economic perspectives with a data envelopment analysis approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(8), pages 1263-1285, November.
    2. Burcay Erus, 2020. "Out of pocket health expenditures in Turkey following introduction of co‐payments along with improved primary care services," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(2), pages 433-440, March.
    3. Mustafa Jahangoshai Rezaee & Abuzar Karimdadi & Hamidreza Izadbakhsh, 2019. "Road map for progress and attractiveness of Iranian hospitals by integrating self-organizing map and context-dependent DEA," Health Care Management Science, Springer, vol. 22(3), pages 410-436, September.
    4. Mina Nejati & Moaven Razavi & Iraj Harirchi & Kazem Zendehdel & Parisa Nejati, 2019. "The impact of provider payment reforms and associated care delivery models on cost and quality in cancer care: A systematic literature review," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-19, April.

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    More about this item

    Keywords

    Efficiency of public hospitals; Health transformation program; Data envelopment analysis; Structural change; Model evaluation; Part-time work; Data envelopment analysis; Linear programming;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • C52 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Evaluation, Validation, and Selection

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