Project description and overall objective
The project entitled Analyse des impacts de la rémunération des médecins sur leur pratique et la performance du système de santé au Québec is funded as part of a concerted action program, Regards sur les modes de rémunération des médecins, which is a joint project of the Commissaire à la santé et au bien-être, the Fonds de recherche Société et Culture – Québec (FRQSC) and the Fonds de recherche en santé – Québec (FRQ-S).
This project’s overall objective is to document of impacts of different physician remuneration models on the effectiveness and performance of Quebec’s health and social services system. The ultimate goal is to identify levers that can have a positive influence on medical practice so that the care and services provided are better adapted to population needs.
Physician remuneration—which refers to both methods and levels of remuneration—is one of the major determinants of medical practice, to be considered along with sociodemographic factors (age, sex, training), norms and values, physician specialty, patient characteristics, and the characteristics of healthcare organizations. As such, remuneration methods and levels influence health system performance. Between 2008 and 2013, the sums expended for physician remuneration grew, on average, by 9.1% annually (CIHI, 2013), or 3 times faster than the GDP. The simultaneous increases in average physician remuneration and in total medical personnel are likely to place enormous pressure on public finances and underscore the importance of ensuring that medical practice contributes effectively to health system performance.
Quebec’s current system of regulations combines different remuneration methods, based in large measure on fee-for-service. Because these methods are in constant evolution, analyzing the links between financial incentives and medical practice is complicated, but this complexity must not be allowed to undermine efforts to study the links between physician remuneration models and health system performance.
Mylaine Breton (Ph.D.), Université de Sherbrooke and Charles-LeMoyne Hospital Research Centre; Arnaud Duhoux (Nurse; Ph.D.), University of Montreal ; Catherine Hudon (M.D., Ph.D., CMFC), Université de Sherbrooke; Alain Vadeboncoeur (M.D.), University of Montreal; François Champagne (Ph.D.), University of Montreal.
CIHI. (2013). National Health Expenditures Database (table NHEX D-1,5,1). Ottawa: Canadian Institute for Health Information.