title: [Physician payment mechanisms. An instrument of health policy].
abstract: Payment mechanisms for physicians have always been subject of debate. The profession tends to prefer fee-for-services, while health care institutions prefer to pay doctors by salary or capitation. The definition of the payment mechanism is not an administrative decision, it is frequently the output of an intense political negotiation. Recently an increase in salaried physicians has been observed, even in countries where the profession is powerful. In nations like Mexico, where the State is the dominant actor, salary or capitation can be used as an instrument to encourage quality of care and better geographic distribution. In this paper, several country cases are reviewed.
authors.affiliation: Centro de Investigaciones en Salud Pública, Instituto Nacional de Salud Pública, Cuernavaca, México.
authors.forename: G
authors.initials: G
authors.lastname: Nigenda
mesh_terms: D002204:Capitation Fee; D018588:Fee-for-Service Plans / Q000191:economics; D006291:Health Policy / Q000191:economics*; D006296:Health Services / Q000191:economics; D006298:Health Services Administration; D006801:Humans; D010820:Physicians / Q000191:economics*; D011057:Politics; D012051:Reimbursement Mechanisms / Q000191:economics*; D012456:Salaries and Fringe Benefits / Q000191:economics
vernacular_title: Mecanismos de pago a los médicos. Instrumento de política sanitaria.