Primary care capitation payments in the UK. An observational study
Primary care capitation payments in the UK. An observational study
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DOI：
10.1186/1472-6963-10-156
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发表时间：
2010-06-08
影响因子：
2.8
通讯作者：
Morgan, Claire L.
中科院分区：
文献类型：
--
作者：
Rhys, Gwion;Beerstecher, Hendrik J.;Morgan, Claire L.
背景：2004年，英格兰和威尔士引入了一个初级保健服务分配公式，以便做法得到公平的报酬。对该公式进行了修改，以使当地卫生当局能够支付实践。苏格兰和北方爱尔兰也采用了类似的支付公式，但这些公式是该国独有的，因此不能包括在本研究中。目的：检查全球总和和对原始公式的修改在多大程度上决定了实践资金。分配公式确定基本的实践收入，全球总和。我们使用原始和修改后的分配公式计算比较了业务部门的全球总和权利。如果全球总和付款低于2004年的历史收入，业务部门将收到收入补贴。我们研究了目前的整体资金水平，以估计什么样的影响将是当收入supplements.Results：几乎每一个威尔士和英语的做法（97%）在2004年收到的收入补充。如果不修改公式，只有72%的威尔士做法需要补充。没有明显的变化会发生在英格兰。公式修改增加了全球总和为99.5%的英语的做法，而它减少了权利为每个威尔士的做法。在2008年威尔士的做法收到约6.15磅（9%）少资金每名患者每年比一个相同的英语做法。这一赤字将增加到11.2%时，最低实践收入guarantee.Conclusions：在不同的英国国家的相同的做法没有得到公平的报酬。这种支付方法对威尔士不利，因为那里的人口年龄较大，健康需求较高。
Background: In 2004 an allocation formula for primary care services was introduced in England and Wales so practices would receive equitable pay. Modifications were made to this formula to enable local health authorities to pay practices.Similar pay formulae were introduced in Scotland and Northern Ireland, but these are unique to the country and therefore could not be included in this study.Objective: To examine the extent to which the Global Sum, and modifications to the original formula, determine practice funding.Methods: The allocation formula determines basic practice income, the Global Sum. We compared practice Global Sum entitlements using the original and the modified allocation formula calculations.Practices receive an income supplement if Global Sum payments were below historic income in 2004. We examined current overall funding levels to estimate what the effect will be when the income supplements are removed.Results: Virtually every Welsh and English practice (97%) received income supplements in 2004. Without the modifications to the formula only 72% of Welsh practices would have needed supplements. No appreciable change would have occurred in England.The formula modifications increased the Global Sum for 99.5% of English practices, while it reduced entitlement for every Welsh practice.In 2008 Welsh practices received approximately 6.15 pound (9%) less funding per patient per year than an identical English practice. This deficit will increase to 11.2% when the Minimum Practice Income Guarantee is abolished.Conclusions: Identical practices in different UK countries do not receive equitable pay. The pay method disadvantages Wales where the population is older and has higher health needs.