Does service "leak" to the fee-for-service sector under an alternative funding method? Experience at a Canadian Academic Health Center

This study was designed to determine whether shifting specialists from fee-for-service practice to annual block funding at an academic health center in Ontario, Canada, would be accompanied by shifts in some of the services provided in the center to specialists who remained in the fee-for-service se...

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Bibliographic Details
Published inResearch in healthcare financial management Vol. 9; no. 1; p. 21
Main Authors Shortt, Samuel E.D, Stanton, Sally
Format Journal Article
LanguageEnglish
Published Towson International Society for Research in Healthcare Financial Management Ltd 01.01.2004
International Society for Research in Healthcare Financial Management
Subjects
Financial management
Funding
Gynecology
Health facilities
Heart surgery
Hospitals
Indigent care
Long term health care
Monetary incentives
Obstetrics
Patients
Payment systems
Physicians
Reimbursement
Specialists
Statistical analysis
Studies
Urology
Workloads
Canada
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Summary:This study was designed to determine whether shifting specialists from fee-for-service practice to annual block funding at an academic health center in Ontario, Canada, would be accompanied by shifts in some of the services provided in the center to specialists who remained in the fee-for-service sector. A data set of the procedural workload was collected for four specialties (Cardiology/Cardiothoracic Surgery, Obstetrics/Gynecology, Orthopaedics, and Urology). Catchment areas were defined for the study center, the four other academic health centers in the province, and for nearby hospitals in the study center's region, using patient postal codes from provincial health insurance data. Patient volumes and patterns of service provision were compared for each provider specialty for 2.5 years before and after the change in funding. The study found no clear trend in migration of care to other centers following initiation of a nonfee-for-service payment plan at an academic health center. [PUBLICATION ABSTRACT]
ISSN:1524-1521