Planning capacity in Primary Health Care under the utilization of case-mix

Primary health care (PHC) represents the first contact between the health care system and the citizens. Over the past years it has been noticed that demand for primary care is increasing. The population is growing older and the prevalence of chronic conditions is increasing. However, the resources provided by the Portuguese National Health System (NHS) are not enough to satisfy the demand, being verified a decrease in primary care accessibility. Patients experience long periods of time to get an appointment with their family physician. The main goal of this study is to show the importance of planning the capacity of PHC under the concept of case-mix, by developing a tool in Excel. The methods applied were based on (Ozen & Balasubramanian 2013) and were adapted to be used by the Portuguese NHS. This tool provides information about the overflow frequency (probability of demand exceeding the available capacity) of every physician in the unit, and allows several scenarios. To test the tool, data from a hypothetical PHC unit were used. The results demonstrated that it is crucial to consider case-mix while planning the physician panels so as to improve the balance between supply and demand and reduce appointment waiting time.