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

Author

Listed:
  • Damien Echevin

    (UdeS - Université de Sherbrooke = University of Sherbrooke [Sherbrooke])

  • Bernard Fortin

    (CIRANO - Centre interuniversitaire de recherche en analyse des organisations [Montréal, Canada] = Center for Interuniversity Research and Analysis on Organizations [Montréal, Canada], ULaval - Université Laval [Québec])

  • Aristide Houndetoungan

    (THEMA - Théorie économique, modélisation et applications - CNRS - Centre National de la Recherche Scientifique - CY - CY Cergy Paris Université)

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 re-hospitalization and mortality after discharge. These effects vary across specialties.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Damien Echevin & Bernard Fortin & Aristide Houndetoungan, 2025. "Healthcare Quality by Specialists Under a Mixed Compensation System: An Empirical Analysis," Post-Print hal-05631318, HAL.
    • Handle: RePEc:hal:journl:hal-05631318
    DOI: 10.1002/hec.4943
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    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C41 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Duration Analysis; Optimal Timing Strategies

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