Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism
Objective: The objectives of the study were to determine General Practitioners' attitudes to National Health Insurance (NHI) and to capitation as a mechanism of reimbursement. The study also aimed to explore determinants of these attitudes. Design: The methodology utilised a cross-sectional survey u...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Public Health and Family Medicine
2017
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613261176766464 |
|---|---|
| access_status_str | Open Access |
| author | Blecher, Mark Stephen |
| author2 | Bachmann, Max |
| author_browse | Bachmann, Max Blecher, Mark Stephen |
| author_facet | Bachmann, Max Blecher, Mark Stephen |
| author_sort | Blecher, Mark Stephen |
| collection | Thesis |
| description | Objective: The objectives of the study were to determine General Practitioners' attitudes to National Health Insurance (NHI) and to capitation as a mechanism of reimbursement. The study also aimed to explore determinants of these attitudes. Design: The methodology utilised a cross-sectional survey using telephone interviews and four focus group discussions. Setting: The study area was the Cape Peninsula area in the Western Cape Province of South Africa. Participants: 174 general practitioners (GPs) were randomly sampled from a total population of 874 GPs in the Cape Peninsula area. Main outcome measures: The main outcome measures were GPs' acceptance of NHI and of capitation as a method of reimbursement. Main results: Sixty three percent of GPs (63,3%) approved of NHI. More than 81 % approved of NHI if GPs were to maintain their independent status, for example their own premises and working hours. Eighty two percent (82,3%) said NHI would be a more equitable system of health care than the system that existed at that time, 88% approved of the fact that NHI would make care by GPs more accessible and 73% said they had the capacity to treat more patients. However, 61,3% of GPs disapproved of capitation as a form of reimbursement. The most common conditions cited by GPs for support of NHI were retention of professional autonomy, fee for service reimbursement and adequate levels of reimbursement. Conclusions: Most GPs in the Cape Peninsula were amenable to some form of NHI. However, approval of NHI is to some extent conditional to details of the NHI system, such as payment mechanisms, workload, income and effects on professional autonomy. The implications of GPs' preferences concerning the reimbursement mechanism for the feasibility of implementing a NHI in South Africa requires serious consideration by policy makers. While this research demonstrates broad ideological and conceptual support for some form of NHI or SHI, further research is required to provide more detailed quantitative information on the trade-offs that GPs would be prepared to make for them to support the introduction of a new socially based insurance system. A national survey of medical practitioners is recommended. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/26635 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:19.547Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2017 |
| publishDateRange | 2017 |
| publishDateSort | 2017 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/26635 Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism Blecher, Mark Stephen Bachmann, Max McIntyre, Di Community Health Health Economics National health insurance Financing Capitation General Practice Objective: The objectives of the study were to determine General Practitioners' attitudes to National Health Insurance (NHI) and to capitation as a mechanism of reimbursement. The study also aimed to explore determinants of these attitudes. Design: The methodology utilised a cross-sectional survey using telephone interviews and four focus group discussions. Setting: The study area was the Cape Peninsula area in the Western Cape Province of South Africa. Participants: 174 general practitioners (GPs) were randomly sampled from a total population of 874 GPs in the Cape Peninsula area. Main outcome measures: The main outcome measures were GPs' acceptance of NHI and of capitation as a method of reimbursement. Main results: Sixty three percent of GPs (63,3%) approved of NHI. More than 81 % approved of NHI if GPs were to maintain their independent status, for example their own premises and working hours. Eighty two percent (82,3%) said NHI would be a more equitable system of health care than the system that existed at that time, 88% approved of the fact that NHI would make care by GPs more accessible and 73% said they had the capacity to treat more patients. However, 61,3% of GPs disapproved of capitation as a form of reimbursement. The most common conditions cited by GPs for support of NHI were retention of professional autonomy, fee for service reimbursement and adequate levels of reimbursement. Conclusions: Most GPs in the Cape Peninsula were amenable to some form of NHI. However, approval of NHI is to some extent conditional to details of the NHI system, such as payment mechanisms, workload, income and effects on professional autonomy. The implications of GPs' preferences concerning the reimbursement mechanism for the feasibility of implementing a NHI in South Africa requires serious consideration by policy makers. While this research demonstrates broad ideological and conceptual support for some form of NHI or SHI, further research is required to provide more detailed quantitative information on the trade-offs that GPs would be prepared to make for them to support the introduction of a new socially based insurance system. A national survey of medical practitioners is recommended. 2017-12-14T09:35:46Z 2017-12-14T09:35:46Z 1999 Master Thesis Masters MMed http://hdl.handle.net/11427/26635 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Community Health Health Economics National health insurance Financing Capitation General Practice Blecher, Mark Stephen Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| thesis_degree_str | Master's |
| title | Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| title_full | Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| title_fullStr | Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| title_full_unstemmed | Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| title_short | Acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| title_sort | acceptability to general practitioners of national health insurance and capitation as a reimbursement mechanism |
| topic | Community Health Health Economics National health insurance Financing Capitation General Practice |
| url | http://hdl.handle.net/11427/26635 |
| work_keys_str_mv | AT blechermarkstephen acceptabilitytogeneralpractitionersofnationalhealthinsuranceandcapitationasareimbursementmechanism |