Public and private funding of general practice services for children and adolescents in New Zealand

Abstract

Objective To measure public and private funding of general practice services for New Zealand children. Methods Computerized records from 111 general practices provided private payments for 118,905 general practice services to children aged 6–17 years. Government subsidies and public insurance payments provided public funding amounts for seven services. Overall and for each service we estimated the ratio of public:private payments (RPPP). Results 64.0% of annual expenditure was public, 36.0% private, (RPPP = 1:0.56). General medical consultations were 67.2% of services (RPPP = 1:0.57); 15.3% were injury-related (RPPP = 1:0.36); 5.2% were prescribing services (all private); 4.9% were immunizations (RPPP = 1:0.12); 2.9% were nursing (RPPP = 1:1.33); 4.4% were administration (all private); and 0.1% were for maternity care (RPPP = 1:0.007). Before capitation funding, public and private funding levels for general medical consultations were similar (RPPP = 1:0.93) but after capitation public payments more than doubled (RPPP = 1:0.40). Conclusion There is a complex of pattern of public and private payments for general practice services for children and adolescents in New Zealand. Both funding sources are critical. Capitation funding changed the balance substantially but did not remove ongoing reliance on private funding to support general practice care for children.