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Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa

BACKGROUND: The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI). South African solo general practitioners (GPs) are unhappy with group practice. There is no clarity on the views of GPs in group practice o...

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Autores principales: Moosa, Shabir, Luiz, John, Carmichael, Teresa, Peersman, Wim, Derese, Anselme
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926723/
https://www.ncbi.nlm.nih.gov/pubmed/27380785
http://dx.doi.org/10.4102/phcfm.v8i1.1025
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author Moosa, Shabir
Luiz, John
Carmichael, Teresa
Peersman, Wim
Derese, Anselme
author_facet Moosa, Shabir
Luiz, John
Carmichael, Teresa
Peersman, Wim
Derese, Anselme
author_sort Moosa, Shabir
collection PubMed
description BACKGROUND: The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI). South African solo general practitioners (GPs) are unhappy with group practice. There is no clarity on the views of GPs in group practice on contracting to the NHI. OBJECTIVES: To describe the demographic and practice profile of GPs in group practice in South Africa, and evaluate their views on NHI, compared to solo GPs. METHODS: This was a descriptive survey. The population of 8721 private GPs in South Africa with emails available were emailed an online questionnaire. Descriptive statistical analyses and thematic content analysis were conducted. RESULTS: In all, 819 GPs responded (568 solo GPs and 251 GPs in groups). The results are focused on group GPs. GPs in groups have a different demographic practice profile compared to solo GPs. GPs in groups expected R4.86 million ($0.41 million) for a hypothetical NHI proposal of comprehensive primary healthcare (excluding medicines and investigations) to a practice population of 10 000 people. GPs planned a clinical team of 8 to 12 (including nurses) and 4 to 6 administrative staff. GPs in group practices saw three major risks: patient, organisational and government, with three related risk management strategies. CONCLUSIONS: GPs can competitively contract with NHI, although there are concerns. NHI contracting should not be limited to groups. All GPs embraced strong teamwork, including using nurses more effectively. This aligns well with the emergence of family medicine in Africa.
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spelling pubmed-49267232016-07-06 Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa Moosa, Shabir Luiz, John Carmichael, Teresa Peersman, Wim Derese, Anselme Afr J Prim Health Care Fam Med Original Research BACKGROUND: The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI). South African solo general practitioners (GPs) are unhappy with group practice. There is no clarity on the views of GPs in group practice on contracting to the NHI. OBJECTIVES: To describe the demographic and practice profile of GPs in group practice in South Africa, and evaluate their views on NHI, compared to solo GPs. METHODS: This was a descriptive survey. The population of 8721 private GPs in South Africa with emails available were emailed an online questionnaire. Descriptive statistical analyses and thematic content analysis were conducted. RESULTS: In all, 819 GPs responded (568 solo GPs and 251 GPs in groups). The results are focused on group GPs. GPs in groups have a different demographic practice profile compared to solo GPs. GPs in groups expected R4.86 million ($0.41 million) for a hypothetical NHI proposal of comprehensive primary healthcare (excluding medicines and investigations) to a practice population of 10 000 people. GPs planned a clinical team of 8 to 12 (including nurses) and 4 to 6 administrative staff. GPs in group practices saw three major risks: patient, organisational and government, with three related risk management strategies. CONCLUSIONS: GPs can competitively contract with NHI, although there are concerns. NHI contracting should not be limited to groups. All GPs embraced strong teamwork, including using nurses more effectively. This aligns well with the emergence of family medicine in Africa. AOSIS 2016-06-15 /pmc/articles/PMC4926723/ /pubmed/27380785 http://dx.doi.org/10.4102/phcfm.v8i1.1025 Text en © 2016. The Authors http://creativecommons.org/licenses/by/2.0/ AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Moosa, Shabir
Luiz, John
Carmichael, Teresa
Peersman, Wim
Derese, Anselme
Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa
title Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa
title_full Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa
title_fullStr Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa
title_full_unstemmed Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa
title_short Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa
title_sort insights of private general practitioners in group practice on the introduction of national health insurance in south africa
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926723/
https://www.ncbi.nlm.nih.gov/pubmed/27380785
http://dx.doi.org/10.4102/phcfm.v8i1.1025
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