Impact of reimbursement systems on child psychiatrists: a comparison of Canada and the United States.

OBJECTIVE

This study measured satisfaction of US and Canadian child psychiatrists with quality of care in their field and behaviors of their payers.

METHOD

US and Canadian child psychiatrists were surveyed concerning time spent on billing paperwork, waiting times for psychiatrist reimbursement and patient treatment, and their satisfaction with psychiatric services and behaviors of payers. Initial and two nonresponder follow-up mailings of the survey were sent in 1992 to all 83 Canadian members of the American Academy of Child and Adolescent Psychiatry and a random sample of 212 US members.

RESULTS

Canadians were significantly more satisfied than Americans with the quality and affordability of services for both inpatients and outpatients. Canadians were less likely to think that third-party payers were annoying or affected their clinical decision-making. Canadians spent less time on billing-related paperwork and received payment more promptly. Canadians, however, reported significantly longer waits for both inpatients and mildly ill outpatients, but not for severely ill outpatients.

CONCLUSIONS

Canadian child psychiatrists were significantly more satisfied with the quality of psychiatric services and the behaviors of their payers, but Canadian patients experienced longer waits.