Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association

Privatising general practice in Mongolia: A trial of needs-adjusted capitation

Don Hindle, Michael O'Rourke, Ravjir Batsuury and Bunijav Orgil

Australian Health Review 22(3) 27 - 43
Published: 1999


Mongolia's family doctors have long been salaried government employees. The crisis caused by the break-up of the Soviet Bloc required the government to seek a balance between command and market economies, and this influenced the decision to introduce capitated private practice for family doctor services on a trial basis. This article explains why and how a risk-adjusted capitation model was developed by a blend of empirical analysis and expert judgement, which comprises ten classes of clients defined by age-sex and poverty groupings. Payment relativities across the classes were set in proportion to a desirable (or target) number of contacts per year. Separate processes were used to set the targets for patient-initiated and active (health promotion and illness prevention) contacts.The model is intended to lead to greater equity of service access and provision. It should also encourage a greater concern for health outcomes, sensitivity to clients' views, and operational efficiency.

© AHHA 1999

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