Abstract
In Poland, as in many other countries, the use of capitation payment schemes in primary health care is popular. Despite this popularity, the subject literature discusses its role in decreasing the quality of primary medical services. This problem is particularly important during COVID-19, when medical entities provide telehealth services to patients. The objective of the study is to examine the effects of COVID-19 pandemic on the performance of the primary health care providers in Poland under a capitation payment scheme. In this study the authors use data from interviews with personnel of medical entities and financial and administrative reports of primary health care providers in order to identify how this crisis situation impacts the performance of primary health care entities, under capitation payment system. The performance indicators include both the financial and quality measures. Selected to the case study primary health care service providers significantly improved their profitability due to considerable costs savings and reduction of services provided to patients in a time of COVID-19 pandemic. Capitation payment system proved to be inefficient, in the studied pandemic period, in terms of the services provided by primary health care service providers to patients and the funds paid to them, in exchange, by the government entities.
Highlights
Primary health care is often described as the foundation of a strong health care system [1]
Four Polish typical primary health care service providers were selected for the present case study, those were clinics which met the following criteria: (1) have been providing primary health care services for at least 5 years; (2) had between 3 to 6 thousand of affiliated patients to general practitioners (GP); (3) whose majority of sales revenues came from National Health Fund (NHF)
This study shows that during a crisis situation such as the COVID-19 pandemic, capitation funding is associated with the improvement of the financial situation and with a deterioration in the efficiency of the primary health care practice assessed on the basis of admission rates and the number of medical services
Summary
Primary health care is often described as the foundation of a strong health care system [1]. According to the World Health Organization (WHO) “All people, everywhere, deserve the right care, right in their community. This is the fundamental premise of primary health care” [2]. Fundamentals of the Primary Health Care (PHC) were presented in the Declaration of Alma-Ata developed during the International Conference on PHC in organized by the WHO and the United Nations Children’s Fund (UNICEF). Based on this declaration, all countries should develop a PHC policy and a comprehensive national health system in order to keep people healthy. It might be achieved by “better use of world’s resources” [3]
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