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The Remuneration of General Practitioners and Specialists in 14 OECD Countries: WHAT ARE THE FACTORS INFLUENCING VARIATIONS ACROSS COUNTRIES?

Auteur : Fujisawa Rie, Lafortune Gaetan
Date de publication : 18/12/2008
Type : Etude
Thème : Santé

Résumé/Sommaire :

This paper provides a descriptive analysis of the remuneration of doctors in 14 OECD countries for which reasonably comparable data were available in OECD Health Data 2007 (Austria, Canada, the Czech Republic, Denmark, Finland, France, Germany, Hungary, Iceland, Luxembourg, Netherlands, Switzerland, the United Kingdom and the United States). Data are presented for general practitioners (GPs) and medical specialists separately, comparing remuneration levels across countries both on the basis of a common currency (US dollar, adjusted for purchasing power parity) and in relation to the average wage of all workers in each country. The study finds that there are large variations across countries in the remuneration levels of GPs, and even greater variations for specialists. Measured as a ratio to the average wage in each country, the remuneration of GPs varies from being two times greater in Finland and the Czech Republic, to three-and-a-half times greater in the United States and Iceland. The remuneration of specialists varies even more, ranging from one-and-a-half times to two times higher than the average wage of all workers for salaried specialists in Hungary and the Czech Republic, to five to seven times higher for self-employed specialists in the Netherlands, the United States and Austria. Some of the variations in remuneration levels across countries may be explained by the use of different remuneration methods ( e.g., salaries or fee-forservices for self-employed doctors), by the role of GPs as gatekeepers, by differences in workload (as measured by working time) and by the number of doctors per capita. However, these institutional and supply-side factors cannot explain all of the variations. Furthermore, when comparing the remuneration of GPs and specialists in each country, this study finds that in nearly all countries, the remuneration of specialists has tended to increase more rapidly than that of GPs over the past decade, thereby widening the income gap. This growing remuneration gap has likely contributed to the rising number and share of specialists in most of these countries over the past decade, resulting in rising concerns about possible shortages of GPs.

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