U.K. study finds investing in primary care results in secondary care savings

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septembre 25, 2017

U.K. researchers report (sub. req.) that stronger investment in primary care would lead to significant savings for secondary care, finding that higher levels of capitation supplement were associated with reduced A&E attendances, reduced emergency admissions, and reduced ambulatory care sensitive conditions (ACSCs) admissions. The study defined three types of practice in England according to the method of allocating capitation payments:

  1. Practices with a national contract (General Medical Services [GMS] practices) that receive capitation payments weighted according to a needs-based formula;
  2. GMS practices with a national contract that, in addition to their weighted capitation payment, receive a capitation supplement based on higher historical budget allocations (mean practice income guarantee [MPIG] payments); and
  3. Practices with a locally negotiated contract (Personal Medical Services [PMS] practices). 

Of the three models, practices in receipt of capitation supplements (MPIG payments) were the only ones to show a clear association between higher levels of funding and reduced secondary care utilization. Additional capitation supplements, rather than additional capitation payments, were associated with reduced secondary care use. The authors suggest the study provides evidence that primary care investment could translate into reductions in secondary care costs, and that capitation payments are broadly aligned to patient need, at least in terms of secondary care usage. They add that supplements to the current capitation formula may reduce secondary care costs.
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More investment in primary care to benefit secondary care - ManagementInPractice

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