Programme no. 223-OP
Health Economics
The need for focus on productivity in General Practice in order to secure sustainable health care.
Morten Gunnersen*1
1Department of Primary Health Care,Region of Southern Denmark,Vejle,Denmark
* = Presenting author
Objectives: The presentation shows the development in productivity for The Region of Southern Denmark (RSD) in general practice from 2008 to 2014. There will also be a use case to illustrate it is possible to rise the production level to the benefit of the community. Finally the presentation will show the differences between the top providers of health care compared with the providers with least value
Background: In order to fulfill the demand for health care, the annual agreement between the State and the regions in Denmark has for more than a decade focused on the rise in productivity amongst the hospital. The same focus has so far not been on either the primary health care in general or on general practice in particular even though the general practitioners (GP) role as gate-keeper.
Results: The analysis shows a limited increase in production amongst the GP’s in RSD. Compared to the increase in numbers of GP’s, the production per doctor seems to decrease. Compared to requirement for productivity towards the hospitals, the production level for GP’s is ca. 10 %>points lower.

The analysis shows that the top 10 providers perform 4-5 times better than the lowest 10 providers and there delivers much more health care service.

Material/Methods: Data was downloaded from The Danish National Health Insurance Service Registry on a annual basis and consist of all patients in RSD in contact with a GP. Data is limited to the period of the 1st of January 2008 to the 31th of December 2014.

The analysis is based on the methods use by the Ministry of Finance and Ministry of Health in Denmark to calculate the value of the service in the hospital sector. To estimate the value of service, the study uses the payment for services to GP’s. In stead of using annual costs for providing health in general practice, the study uses the numbers of GP’s who have a contract with RSD for providing health care.

Conclusion: The health care sector is supply induced and therefore the GP’s have a huge influence on planning when and how much they want to work.

The challenge of increasing health inequalities and demographic changes is evident. The analysis shows that there is a great potential for meeting the challenges if GP’s with relative low production get motivated to deliver more health care services in order to cope with multi-morbidity, quicker hospital discharges, nutrition counseling etc.

Points for discussion: How can we encourage GP’s with relative low production to generate more medical service?

What are the long-term medical consequences going to be if we do not succeed to encourage those GP’s?