Unlike other weighted capitation schemes used in Irish health service financing and in health systems internationally, the GMS capitation payments scheme for General Practitioners lacks transparency in both the data used and the model employed. In this study, evidence-based weights were generated and compared to current payment weights.
Four datasets on GP utilisation were interrogated.
Evidence-based weights indicated that over 70s had higher payments per consultation than other groups. Considerable intra-age band differences in capitation payment were detected.
Discussion and conclusion
The results suggest that there is a need for a comprehensive review of the current payments system. Current age bands should be narrowed. The implications for the efficiency and equity of general practice in Ireland are discussed.
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Although beyond the scope of this study due to data limitations, under 6 s, who are universally entitled to visit GPs for free (at point of contact) since 2015, received a capitation payment of €125 per annum. Before this change, the drop in capitation payment for those who remain on the GMS scheme at age 6 was €30.17, a 41% fall. Since 2015, the fall is at least €81.47, a 65% fall.
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McElroy, B. Empirically derived weights for GMS capitation payments to General Practitioners. Ir J Med Sci 186, 471–476 (2017). https://doi.org/10.1007/s11845-016-1548-x
- Weighted capitation
- General Medical Services Scheme
- General practice
- Health care financing