[Risk adjusted capitation is the basis for general practitioners' renumeration]

Abstract

The health care renumeration poses a great challenge for both politicians and policymakers. During the beginning of the 1990s, following the end of communism in Hungary, the reform of health care began with the introduction of the primary health care (PHC), specifically with general practitioner (GPP)/family medicine (FM) care. The basis of the renumeration was the age-adjusted capitation built upon the free choice of doctors, while social security renumeration was built on a mixed system. Several pros and cons have been highlighted, but the underlying principle has proved to be simple and effective. Comparison of the European and Hungarian characteristics, analysis of data in the present patient care report as well as in the years preceding the release of the aforementioned document, these confirm that the method of capitation-based remuneration is a fundamental, easy, and unmanipulable method. It places minimal weight on social security and comes with little costs. Orv Hetil. 2019; 160(27): 1057-1063.

Keywords: GP (general practitioner); GP (általános orvos); age-related morbidity; capitation; fee for service; kapitáció; patient care report; risk adjusted capitation; rizikó/kor korrigált fejkvóta; social security number; társadalombiztosítási azonosító jel (taj); tételes betegforgalmi jelentés; életkorhoz kötött morbiditás.