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Journal of Public Health Advance Access published online on May 20, 2008
Journal of Public Health, doi:10.1093/pubmed/fdn038
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© The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Effects of a fixed-payment method on demand for imaging tests in a university hospital


Tacettin Inandi, Associate Professor1
Cahit Ozer, Assistant Professor2
Ali Balci, Assistant Professor3
Sinem Karazincir, Assistant Professor3

1 Department of Public Health, Medical Faculty, Mustafa Kemal University, 31100-Hatay, Turkey
2 Department of Family Medicine, Medical Faculty, Mustafa Kemal University, 31100-Hatay, Turkey
3 Department of Radiology, Medical Faculty, Mustafa Kemal University, 31100-Hatay, Turkey


Address correspondence to Tacettin Inandi, E-mail: inandit{at}gmail.com


  Abstract

Background In 2006, a new medical payment framework such as fixed-payment method was implemented in Turkey and then cancelled 5 months later. The aim of this study was to explore the effects of this payment method on the demand for imaging tests.

Methods Data were obtained retrospectively from electronic medical records. The main outcome measures were the number of imaging tests, the payment per outpatient and the rate of negative results of imaging tests.

Results The overall mean number of imaging tests per outpatient was 0.75 ± 0.13. This value decreased significantly after implementation of the fixed-payment method, and then increased after its cancellation (P < 0.01). The overall mean payment per outpatient was $14.1 ± 2.3. For patients with social security, there was a significant decrease in the mean payment after implementation of the new method, followed by an increase after its cancellation (P = 0.02); in contrast, no significant changes were observed in patients not covered by social security (P > 0.05). No significant differences were observed in the rate of negative results for imaging tests (P > 0.05).

Conclusions The use of a fixed-payment method reduces the demand for imaging tests when there is a strong financial relationship between the hospital and its personnel.

Keywords: fixed-payment method, hospitals, imaging tests, overuse


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