Towards a differentiated capitation system: relation between patient characteristics, contacts and costs.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 26082456.
- Also identified by DOI 10.1093/fampra/cmv043.
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Abstract
BACKGROUND AND OBJECTIVE: A new payment system could curb primary health care costs. A differentiated capitation system based on patient characteristics could be the best mix for payment. To test the feasibility of such a system, we examined the number of contacts between patients and general practitioners (GPs), the related costs and the relationship with age, sex and comorbidity. METHODS: A retrospective observational study included 29304 primary care patients in the Netherlands. Age, sex and comorbidity were related to number of contacts per patients per year and costs using a negative binomial regression analysis. RESULTS: Males, younger patients and patients with no comorbidities visit their GP least often. Medically unexplained physical symptoms, diabetes and severe back complaints generate the most contacts; diabetes is specifically related to higher costs. CONCLUSION: Several patient characteristics are related to the number of contacts patients have with their GP and the consecutive remuneration. This study can be used as an input to create a differentiated capitation system.