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Healthcare Quality by Specialists Under a Mixed Compensation System: An Empirical Analysis

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  • Damien Echevin
  • Bernard Fortin
  • Aristide Houndetoungan

Abstract

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.

Suggested Citation

  • Damien Echevin & Bernard Fortin & Aristide Houndetoungan, 2025. "Healthcare Quality by Specialists Under a Mixed Compensation System: An Empirical Analysis," Health Economics, John Wiley & Sons, Ltd., vol. 34(5), pages 972-991, May.
    • Handle: RePEc:wly:hlthec:v:34:y:2025:i:5:p:972-991
    DOI: 10.1002/hec.4943
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    References listed on IDEAS

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