Money talks: performance-based reimbursement systems impact on perceived work, health and patient care for physicians in Sweden

Introduction The study aimed to investigate in which way performance-based reimbursement (PBR) systems Swedish healthcare services (1) subjectively impacted physicians’ work and patient care (2) were associated with the occurrence of stress-induced exhaustion disorders among physicians. Method applied a mixed-method design. Data collected from representative sample In questionnaire, respondents asked answer an open-ended question regarding their reflections on PBR. answers analysed using thematic analysis. Respondents also rate impact PBR work. association between self-rated disease was logistic regressions. Stress-induced disorder measured Burnout Assessment Scale. Results Thematic analysis resulted four themes: Money talks, Patients are affected, (3) Medical morals challenged, (4) increase quantity illegitimate tasks. Logistic regressions showed that physicians who experienced had two-fold higher risk disorder. Discussion Our findings suggest current Sweden play essential role negatively influence health. Also, patients negatively. No previous has explored potentially harmful how perceive work, health care. indicate policymakers should be encouraged deeply review focus ways they can limit negative while meeting future challenges.