Ir J Med Sci. 2017 Jan 18. doi: 10.1007/s11845-016-1548-x. [Epub ahead of print]

Empirically derived weights for GMS capitation payments to General Practitioners.

McElroy B.

Abstract

AIM:

Unlike other weighted capitation schemes used in Irish health service financing and in health systems internationally, the GMS capitation payments scheme for General Practitioners lacks transparency in both the data used and the model employed. In this study, evidence-based weights were generated and compared to current payment weights.

METHODS:

Four datasets on GP utilisation were interrogated.

RESULTS:

Evidence-based weights indicated that over 70s had higher payments per consultation than other groups. Considerable intra-age band differences in capitation payment were detected.

DISCUSSION AND CONCLUSION:

The results suggest that there is a need for a comprehensive review of the current payments system. Current age bands should be narrowed. The implications for the efficiency and equity of general practice in Ireland are discussed.

KEYWORDS:

General Medical Services Scheme; General practice; Health care financing; Weighted capitation

PMID:28101824DOI:10.1007/s11845-016-1548-x

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