TY - JOUR
T1 - Relationship between general practice capitation funding and the quality of primary care in England
T2 - a cross-sectional, 3-year study
AU - L'Esperance, Veline Sabrina
AU - Gravelle, Hugh
AU - Schofield, Peter
AU - Santos, Rita
AU - Ashworth, Mark
PY - 2019
Y1 - 2019
N2 - Objective To explore the relationship between general practice capitation funding and quality ratings based on general practice inspections.Design Cross-sectional study pooling 3 years of primary care administrative data.Setting UK primary care.Participants 7310 practices (95% of all practices) in England which underwent Care Quality Commission (CQC) inspections between November 2014 and December 2017.Main outcome measures CQC ratings. Ordered logistic regression methods were used to predict the relationship between practice capitation funding and CQC ratings in each of five domains of quality: caring, effective, responsive, safe and well led, together with an overall practice rating.Results Higher capitation funding per patient was significantly associated with higher CQC ratings across all five quality domains: caring (OR 1.14, 95% CI 1.04 to 1.23), effective (OR 1.08, 95% CI 1.00 to 1.16), responsive (OR 1.09, 95% CI 1.02 to 1.17), safe (OR 1.11, 95% CI 1.05 to 1.18), well led (OR 1.13, 95% CI 1.06 to 1.20) and overall rating (OR 1.13, 95% CI 1.06 to 1.19).Conclusion Higher capitation funding was consistently associated with higher ratings across all CQC domains and in the overall practice rating. This study suggests that measured dimensions of the quality of care are related to the underlying capitation funding allocated to each general practice, implying that additional capitation funding may be associated with higher levels of primary care quality.
AB - Objective To explore the relationship between general practice capitation funding and quality ratings based on general practice inspections.Design Cross-sectional study pooling 3 years of primary care administrative data.Setting UK primary care.Participants 7310 practices (95% of all practices) in England which underwent Care Quality Commission (CQC) inspections between November 2014 and December 2017.Main outcome measures CQC ratings. Ordered logistic regression methods were used to predict the relationship between practice capitation funding and CQC ratings in each of five domains of quality: caring, effective, responsive, safe and well led, together with an overall practice rating.Results Higher capitation funding per patient was significantly associated with higher CQC ratings across all five quality domains: caring (OR 1.14, 95% CI 1.04 to 1.23), effective (OR 1.08, 95% CI 1.00 to 1.16), responsive (OR 1.09, 95% CI 1.02 to 1.17), safe (OR 1.11, 95% CI 1.05 to 1.18), well led (OR 1.13, 95% CI 1.06 to 1.20) and overall rating (OR 1.13, 95% CI 1.06 to 1.19).Conclusion Higher capitation funding was consistently associated with higher ratings across all CQC domains and in the overall practice rating. This study suggests that measured dimensions of the quality of care are related to the underlying capitation funding allocated to each general practice, implying that additional capitation funding may be associated with higher levels of primary care quality.
KW - general practice
KW - health economics
KW - health inequalities
KW - primary care
KW - primary care funding
KW - quality in health care
UR - http://www.scopus.com/inward/record.url?scp=85074732652&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-030624
DO - 10.1136/bmjopen-2019-030624
M3 - Article
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e030624
ER -