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Open Access Research article

International developments in revenues and incomes of general practitioners from 2000 to 2010

Madelon Kroneman1*, Pascal Meeus2, Dionne Sofia Kringos3, Wim Groot4 and Jouke van der Zee5

Author Affiliations

1 NIVEL Netherlands Institute of Health Services Research, P.O Box 1568, 3500, BN Utrecht, The Netherlands

2 RIZIV, 1150 Brussels, Belgium

3 Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

4 Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

5 Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands

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BMC Health Services Research 2013, 13:436  doi:10.1186/1472-6963-13-436

Published: 24 October 2013

Abstract

Background

The remuneration system of General Practitioners (GPs) has changed in several countries in the past decade. The aim of our study was: to establish the effect of these changes on the revenues and income of GPs in the first decade of the 21st century.

Methods

Annual GP revenue and practice costs were collected from national institutes in the eight countries included in our study (Belgium, Denmark, Finland, France, Germany, The Netherlands, Sweden, The United Kingdom (UK)) from 2000–2010. The data were corrected for inflation and purchasing power. Data on the remuneration systems and changes herein were collected from the European Observatory Health Systems Reviews and country experts.

Results

Comprehensive changes in the remuneration system of GPs were associated with considerable changes in GP income. Incremental changes mainly coincided with a gradual increase in income after correction for inflation. Average GP income was higher in countries with a strong primary care structure.

Conclusions

The gap between the countries where GPs have a lower income (Belgium, Sweden, France and Finland) and the countries where GPs have a higher income (Netherlands, Germany and the UK) continues to exist over time and appeared to be related to dimensions of primary care, such as governance and access. New payment forms, such as integrated care payment systems, and new health care professionals that are working for GPs, increasingly blur the line between practice costs and income, making it more and more important to clearly define expenditures on GPs, to remain sight on the actual income of GPs.

Keywords:
General practice; Income; International comparative research