Capitation based prescribing budgets will not work
نویسندگان
چکیده
General practice prescribing costs have risen rapidly in recent years, and there are wide variations between practices in rates and costs of prescribing. Setting general practice prescribing budgets with a capitation based formula seems to offer a solution to these problems. However, capitation based formulas may unfairly penalise legitimate variations and increases in prescribing costs. We therefore asked Azeem Majeed and Trisha Greenhalgh to give their views on the subject.
منابع مشابه
Derivation of a needs based capitation formula for allocating prescribing budgets to health authorities and primary care groups in England: regression analysis.
OBJECTIVE To develop a weighted capitation formula for setting target allocations for prescribing expenditures for health authorities and primary care groups in England. DESIGN Regression analysis relating prescribing costs to the demographic, morbidity, and mortality composition of practice lists. SETTING 8500 general practices in England. SUBJECTS Data from the 1991 census were attribut...
متن کاملASSET (Age/Sex Standardised Estimates of Treatment): A Research Model to Improve the Governance of Prescribing Funds in Italy
BACKGROUND The primary objective of this study was to make the first step in the modelling of pharmaceutical demand in Italy, by deriving a weighted capitation model to account for demographic differences among general practices. The experimental model was called ASSET (Age/Sex Standardised Estimates of Treatment). METHODS AND MAJOR FINDINGS Individual prescription costs and demographic data ...
متن کاملUse of risk adjustment in setting budgets and measuring performance in primary care II: advantages, disadvantages, and practicalities.
costs: implications for setting and monitoring prescribing budgets. Health Trends 1996;28:52-5. 2 Hippisley-Cox J, Hardy C, Pringle M, Fielding K, Carlisle R, Chilvers C. The effect of deprivation on variations in general practitioners’ referral rates: a cross sectional study of computerised data on new medical and surgical outpatient referrals in Nottinghamshire. BMJ 1997;314:1458-61. 3 Reid F...
متن کاملAnalysis of the ability of the new needs adjustment formula to improve the setting of weighted capitation prescribing budgets in English general practice.
“wrong” sign, but the variable seems counterintuitive only if considered in isolation. Consideration of other variables in the model makes the reason clear. Variables with counterintuitive sign compensate for the excess effects of other variables in the model, so that excluding them removes this opportunity for negative feedback. The result is a model that is both less subtle and less predictiv...
متن کاملUse of risk adjustment in setting budgets and measuring performance in primary care I: how it works.
Healthcare systems in countries throughout the developed world are faced with the problem of limiting the growth in spending on health services while ensuring that their populations have access to appropriate care. The United Kingdom is no different in this respect, and the past 20 years have seen the introduction of numerous initiatives aimed at improving the efficiency of the NHS. Approaches ...
متن کامل