Salaried and fee-for-service general practitioners: is there a difference in patient turnover? 1994

A Bjørndal, and E Arntzen, and A Johansen
National Institute of Public Health, Unit of Health Services Research, Oslo, Norway.

OBJECTIVE To compare use of working hours, patient turnover, and patient characteristics in two general practitioner groups which differed in contractual arrangements and income levels (partly fee-for-service vs. salary). METHODS Cross-sectional study of all patient contacts during one week. METHODS All general practitioners (GPs) in Oslo (N = 263) with contracts with the municipality. 83% participated. METHODS Time spent in various types of work and patient turnover; the number of patients seen per hour of consultation time. RESULTS Fee-for-service GPs worked almost exclusively with patients in their own practice, while salaried GPs spent more time out of office (consultation-based patient work constituting 55% of the working hours). The fee-for-service group registered on average 2.68 consultations per hour of patient contact (95% confidence interval: 2.51-2.84). The corresponding numbers for the salaried group were 2.37 (2.24-2.50). Salaried GPs had somewhat more telephone consultations per hour (2.01 vs 1.66 for fee-for-service GPs), leaving a picture of two GP groups with small differences in patient turnover. The two patient populations were remarkably similar and so was the general practitioners' own evaluation of the consultations. CONCLUSIONS Over a number of years the GPs in Oslo have practised under different contractual arrangements. As a consequence of different expectations and incentives it was expected that consultation activity and patient populations had evolved differently. This proved not to be the case.

UI MeSH Term Description Entries
D008297 Male Males
D009664 Norway A country located in northern Europe, bordering the North Sea and the Atlantic Ocean, west of Sweden. The capital is Oslo. Kingdom of Norway
D010818 Practice Patterns, Physicians' Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided. Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005194 Family Practice A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. Family Practices,Practice, Family,Practices, Family
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001071 Appointments and Schedules The different methods of scheduling patient visits, appointment systems, individual or group appointments, waiting times, waiting lists for hospitals, walk-in clinics, etc. Patient Appointments,Patient Schedules,Schedules, Patient,Appointments,Schedules,Appointment,Appointment, Patient,Appointments, Patient,Patient Appointment,Patient Schedule,Schedule,Schedule, Patient,Schedules and Appointments
D012456 Salaries and Fringe Benefits The remuneration paid or benefits granted to an employee. Fringe Benefits,Wages,Paternity Benefits,Pay Equity,Salaries,Benefit, Fringe,Benefit, Paternity,Benefits, Fringe,Benefits, Paternity,Equities, Pay,Equity, Pay,Fringe Benefit,Paternity Benefit,Pay Equities,Salary,Wage
D012737 Sex Factors Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances. Factor, Sex,Factors, Sex,Sex Factor

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