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More equitable systems for allocating general practice deprivation payments: financial consequences

D O'Reilly1, K Steele

  • 1Health and Health Care Research Unit, Queen's University of Belfast, Northern Ireland. d.oreilly@qub.ac.uk

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|November 4, 1998
PubMed
Summary

New models for general practitioner (GP) deprivation payments in Northern Ireland show that more equitable funding is possible. However, these changes would significantly redirect funds between areas, potentially requiring transitional payments.

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Area of Science:

  • Health Services Research
  • Public Health Policy
  • Geographic Health Information Systems

Background:

  • The allocation of general practitioner (GP) deprivation payments is a contentious issue.
  • Current systems may not be equitable, with proposals for enumeration district allocation and graded Jarman scores.
  • The impact of these proposed changes on payment distribution remains unquantified.

Purpose of the Study:

  • To investigate the resource implications of proposed modifications to GP deprivation payment allocation in Northern Ireland.
  • To assess how changes in allocation methods affect fund distribution.

Main Methods:

  • Modeling three alternative systems for GP deprivation payments.
  • Incorporating proposed changes like enumeration district allocation and graded Jarman scores.

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  • Determining the reallocation of deprivation payments between geographical areas.

    • Main Results:

    • The proportion of the population eligible for payments varies by scheme design.
    • Systems with lower Jarman score thresholds and more payment bands increase eligible areas and populations significantly (2-3x).
    • All modeled alternatives redirect funds from currently funded areas to previously unfunded areas, with the greatest loss from 'low' and least from 'high' payment bands.

    Conclusions:

    • More equitable methods for allocating GP deprivation payments are feasible.
    • These equitable alternatives necessitate substantial fund redistribution between areas.
    • Transitional payment mechanisms may be required to manage these shifts in funding.