IDEAS home Printed from https://ideas.repec.org/p/hpa/wpaper/199710.html
   My bibliography  Save this paper

Needs-based Primary Medical Care Capitation: Development and Evaluation of Alternative Approaches

Author

Listed:
  • B Hutchison
  • J Hurley
  • S Birch
  • J Lomas
  • S Walter
  • J Eyles
  • F Stratford-Devai

Abstract

Objective. To develop and evaluate alternative methods of adjusting primary medical care capitation payments for variations in relative need for health care among enrolled practice populations. Methods. We developed alternative needs-based capitation formulae and applied them to a sample of capitation-funded primary care practices to assess each formula's performance against a reference standard of capitation payments based on age, sex and self-assessed health status of the enrolled populations. The alternative formulae were based on: (1) age and sex; (2) age, sex and individually-measured socioeconomic characteristics; (3) age, sex and socioeconomic characteristics imputed from census data for enrollees' neighbourhood of residence; (4) age, sex and standardized mortality ratio for enrollees' neighbourhood of residence. Results. Age/sex-adjusted capitation payments for the six practices studied ranged from 10% higher to 18% lower than the reference standard payments. Capitation formulae based on socioeconomic and mortality data did not perform consistently better than the current age/sex-based formula. Conclusions. Primary medical care capitation payments adjusted only for age and sex do not reflect the relative health care needs of enrolled practice populations. Our alternative formulae based on socioeconomic and mortality data also failed to reflect relative needs. Methods that use other approaches to adjusting for differences in relative need among enrolled populations should be investigated. Copyright Kluwer Academic Publishers 2000
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • B Hutchison & J Hurley & S Birch & J Lomas & S Walter & J Eyles & F Stratford-Devai, 1997. "Needs-based Primary Medical Care Capitation: Development and Evaluation of Alternative Approaches," Centre for Health Economics and Policy Analysis Working Paper Series 1997-10, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    • Handle: RePEc:hpa:wpaper:199710
    as

    Download full text from publisher

    File URL: http://www.chepa.org/Research-Products/Working-Papers/Working-Papers-Archive
    Download Restriction: no
    ---><---

    Other versions of this item:

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Vargas, Veronica & Wasem, Jürgen, 2002. "Using selected diagnoses to improve the Chilean capitation formula," Wirtschaftswissenschaftliche Diskussionspapiere 06/2002, University of Greifswald, Faculty of Law and Economics.
    2. Asada, Yukiko & Kephart, George & Hurley, Jeremiah & Yoshida, Yoko & Smith, Andrea & Bornstein, Stephen, 2012. "The role of proximity to death in need-based approaches to health care," Health Policy, Elsevier, vol. 106(3), pages 291-302.
    3. Verónica Vargas & Juergen Wasem, 2005. "Risk Adjustment and Primary Health Care in Chile," ILADES-UAH Working Papers inv162, Universidad Alberto Hurtado/School of Economics and Business.
    4. Fainman, Emily Zhu & Kucukyazici, Beste, 2020. "Design of financial incentives and payment schemes in healthcare systems: A review," Socio-Economic Planning Sciences, Elsevier, vol. 72(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hpa:wpaper:199710. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Lyn Sauberli (email available below). General contact details of provider: https://edirc.repec.org/data/chepaca.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.