Under the EEG 2014, direct marketing has been made obligatory for all but small-scale plants, with the market premium as the standard mode of remuneration (from 2015, all new RES plants > 500 kWel have to participate in direct marketing, from 2016 this is the case for all new plants > 100 kWel (§ 37 EEG 2014)).
Most of the respondents believe that the FFS mode of remuneration influences how GPs deliver services.
There was also a consensus among the interviewees that mode of remuneration influences the length of consultations.
(GP: private clinic, rural) Another facet of time management affected by mode of remuneration is the proportion of time GPs devote to regular appointments versus walk-in services.
The primary constraint of this mode of remuneration, according to FFS physicians, is that complex acts are under-remunerated: " There are some blatant injustices with FFS.
At the clinic level, determinants included the availability of psychotherapy on-site, the use of treatment algorithms, and the mode of remuneration.
The international differences were related to characteristics of the health care systems, such as the GPs' employment status, gate keeping role and mode of remuneration [ 45, 46, 49].
We found that for a large proportion of the clinics, the inadequate mode of remuneration and the lack of time for follow-up were significant barriers.
Among the barriers to adequacy, the two variables considered were the lack of time for follow-up and the inadequate mode of remuneration to offer an "optimal level" of care for patients suffering from anxiety or depressive disorders.
While numerous studies have investigated, for example, the impact of mode of remuneration on GPs' behaviours, the original contribution of our study is its demonstration of the interconnectedness between different factors forming complex causal loops.
