Bahari Nor Izyani, Baharom Mazni, Zahid Syahidatun Najwa Abu, Daud Faiz
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Graduate School of Business, SEGI University, Jalan Teknologi, Kota Damansara, Selangor, Malaysia.
Iran J Public Health. 2022 Jul;51(7):1469-1480. doi: 10.18502/ijph.v51i7.10081.
With growing healthcare (HC) expenditures and limited funding, policymakers need to find new ways to provide healthcare that is affordable and fair. There are many methods for paying specialists, and the three basic payment methods include fee-for-service (FFS), capitation, and salary. This review focuses on identifying published articles related to the different methods used for paying specialists for their service and further highlights their advantages and disadvantages.
The research was designed and carried out in line with the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) checklist. Five databases were used in the literature search ie: Scopus, Web of Science, Ovid Medline, EBSCOhost, and PubMed in 2020. The search term used revolved around physician, payment method and specialist behavior.
Databases were searched electronically using EndNote X9.2, wherein 588 related studies of literature were included. Meanwhile, it went down to 546 related studies after the title and abstract screening was conducted in order to eliminate duplicates. In total, 24 studies were then left to be reviewed in full text; finally, 12 studies were integrated into this analysis after a description of the entire text of the studies.
Payment methods can affect physician practice behaviors and the quality of healthcare. The combination of payment methods may, however, combine the benefits of simple payment methods. Where there is not adequate mixing of methods, bonus-for-performance programs may encourage the provision of targeted services. Thus, before a new medical policy is implemented, policymakers must define and empirically examine the positive and negative impacts.
随着医疗保健（HC）支出的不断增加以及资金有限，政策制定者需要找到新的方法来提供负担得起且公平的医疗保健服务。支付专科医生费用的方法有很多种，三种基本的支付方式包括按服务收费（FFS）、按人头付费和薪资制。本综述着重于识别已发表的与支付专科医生服务费用的不同方法相关的文章，并进一步突出它们的优缺点。
本研究按照“系统评价与Meta分析的首选报告项目”（PRISMA）清单进行设计和实施。2020年在文献检索中使用了五个数据库，即：Scopus、科学网、Ovid Medline、EBSCOhost和PubMed。所使用的检索词围绕医生、支付方式和专科医生行为展开。
使用EndNote X9.2对数据库进行电子检索，其中纳入了588项相关文献研究。同时，在进行标题和摘要筛选以消除重复项后，相关研究数量降至546项。总共剩下24项研究进行全文审查；最后，在对这些研究的全文进行描述后将12项研究纳入本分析。
支付方式会影响医生的执业行为和医疗保健质量。然而，支付方式的组合可能会结合简单支付方式的优点。在方法没有充分混合的情况下，绩效奖金计划可能会鼓励提供有针对性的服务。因此，在实施新的医疗政策之前，政策制定者必须界定并实证检验其正面和负面影响。
