Risks and Benefits of the Use of Capitation Formulae in Primary Care
AbstractIncreasingly, primary care physicians are being given budgets based on capitation formulae in the belief that such budgets will be fairer than budgets based on the historical utilization of funds. A second reason for giving primary care physicians budgets based on capitation formulae is that governments hope this will lead to beneficial changes in the behavior of physicians, for example, leading to healthcare resources being used more efficiently and appropriately. Ultimately capitation formulae are expected to produce financial benefits that can be reinvested in better clinical services for patients. In this paper these three key objectives are discussed using examples where capitation formulae have been used. There is limited evidence of the benefits of using capitation formulae but this evidence mainly comes from observational studies that are prone to bias and confounding. A major deficiency with the current capitation formulae used to allocate budgets to primary care physicians in England is that they generally only contain weightings for age, sex, and one or more ecological measures of need. Risk adjustment models have been used in the US but these models can explain only a small proportion of the variation in healthcare costs. At present in the UK it is uncertain whether capitation-based budgets and the enforced collaborative working arrangements for general practitioners will lead to a more efficient and equitable National Health Service. Continued evaluation of how capitation formulae are developed, the methods to adequately adjust for clinical risk, and how capitation formulae change clinical practice are required.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Springer Healthcare | Adis in its journal Disease Management & Health Outcomes.
Volume (Year): 10 (2002)
Issue (Month): 4 ()
Contact details of provider:
Web page: http://diseasemanagement.adisonline.com/
Healthcare expenditure; Pharmacoeconomics;
Find related papers by JEL classification:
- C - Mathematical and Quantitative Methods
- D - Microeconomics
- I - Health, Education, and Welfare
- Z - Other Special Topics
- I1 - Health, Education, and Welfare - - Health
- I19 - Health, Education, and Welfare - - Health - - - Other
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
You can help add them by filling out this form.
reading list or among the top items on IDEAS.Access and download statisticsgeneral information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin).
If references are entirely missing, you can add them using this form.