Abstract

HESPANHOL, Alberto  and  PINTO, Alexandre Sousa. The payment model in São João Health Center: "Tubo de Ensaio". Arq Med [online]. 2005, vol.19, n.3, pp.113-120. ISSN 2183-2447.

The aims of this paper was todescribe the experiment on doctors’ remunerations in the São João Health Centre and to find an eventual correlation between its evolution and the prescription of medicines (MD’s) and diagnostic tests (EAD’s) during five years at work. Doctors’ gross remunerations were noted monthly from the account of the Department of General Practice, and separated into its components; the amounts spent in MDs and EAD’s were registered monthly, from the Porto Health Sub Region. After starting the new remunerative system, in the second semester of 2002, the incomes showed an upward tendency, continued during the first semester of 2003. During the second semester of 2003 and the year 2004, along with the application of changes to the remunerative system, there was a tendency for stability or even a downward tendency of the incomes. In the beginning of 2002, there was an upward tendency of the total expenses, which was maintained all over 2002 and the next two years. Expenses in MD increased steadily while those with EAD’s were stable. It was not found an evident relationship between doctors’ incomes and expenses in MD’s and EAD’s, permitting the allegation that the incentives to the productivity in the conditions established in this Health centre do not have remarkable consequences on the expenses. The incentives established in this experiment resulted in an average increase of the incomes in about 40%, the most significant contribution being given by the incentives to rational prescription.

Keywords : Health Care Quality; Management Quality; Doctors’ Remuneration; Primary Health Care; General Practice; Family Medicine.

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