Penetrating the "black box": financial incentives for enhancing the quality of physician services - PubMed (original) (raw)

Review

. 2004 Sep;61(3 Suppl):37S-68S.

doi: 10.1177/1077558704266770.

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• PMID: 15375283
• DOI: 10.1177/1077558704266770

Review

Penetrating the "black box": financial incentives for enhancing the quality of physician services

Douglas A Conrad et al. Med Care Res Rev. 2004 Sep.

Abstract

This article addresses the impact of financial incentives on physician behavior, focusing on quality of care. Changing market conditions, evolving social forces, and continuing organizational evolution in health services have raised societal awareness and expectations concerning quality. This article proceeds in four parts. First, the authors place financial incentives in the context of broader forces shaping the quality of physician services. Second, the article reviews the literature on financial incentive effects on physician behavior. Third, a simple net income maximization model of physician choices is presented, from which are derived formal hypotheses regarding the effect of financial incentives on physician choices of quality per unit of physician service and the quantity of services per patient. The model is extended qualitatively to offer further hypotheses and research directions. Finally, gaps and limitations of the model and of the extant empirical research are articulated, and additional researchable questions are posed.

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Comment in

• Commentary on "Penetrating the 'black box': financial incentives for enhancing the quality of physician services," by Douglas A. Conrad and Jon B. Christianson.
  Landon BE. Landon BE. Med Care Res Rev. 2004 Sep;61(3 Suppl):69S-75S. doi: 10.1177/1077558704267505. Med Care Res Rev. 2004. PMID: 15375284 No abstract available.
• Individual incentives to fix organizational problems?
  Gray BH. Gray BH. Med Care Res Rev. 2004 Sep;61(3 Suppl):76S-9S. doi: 10.1177/1077558704267506. Med Care Res Rev. 2004. PMID: 15375285 No abstract available.

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