GP payment schemes review

We conducted a review of the literature on primary care physician (Eg family doctor, general practitioner or other generalist working in a community setting) payment, methods and their impacts on physician behaviour. A comprehensive search of databases identified a large number of studies, of which thirty six were included in the final review. Although we were interested in looking at a wide range of outcomes, the majority of the evidence related to activity volume, referrals, supplier-induced demand, patient pre selection and prevention. Our review therefore focused on the evidence around the effects of the three main remuneration methods (fee-for-service (FFS), capitation and salary) on these outcomes. We also considered mixed systems of the main methods. The studies included in the review spanned qualitative, quantitative, mixed method research and RCTs.