GDPs' views on alternative renumeration systems

Abstract

Objective To identify GDPs preferences for differing remuneration mechanisms and their beliefs on the effect of the mechanisms in care provision. Design Postal questionnaire survey of 300 GDPs holding an NHS contract with a London Health Authority. Results GDPs perceive that remuneration mechanisms are important in determining the provision of care but not overall disease levels. There were differences in the preferred remuneration mechanisms when working under the NHS compared with the non-NHS sector. When providing care under the NHS, either the current remuneration system or a salaried plus bonus would be the preferred choice, while for non-NHS care a fee-per-item mechanism is preferred. Fee-per-item arrangement was the preferred choice of younger general practitioners compared with older practitioners. Females showed a greater preference for a salaried with bonus arrangement compared with males. Conclusions If policy makers are to use remuneration mechanisms to influence the provision of care effectively, the beliefs that care providers hold about various mechanisms are important to understand how they would respond to changes in the system.