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

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.