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Towards a differentiated capitation system: relation between patient characteristics, contacts and costs
Marijke Olthof1, Feikje Groenhof2, Marjolein Y Berger2
1Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. marijkeolthof@gmail.com.
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.
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