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Medical Journal of Islamic Republic of Iran، جلد ۳۶، شماره ۱، صفحات ۷-۲۱
عنوان فارسی
چکیده فارسی مقاله
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عنوان انگلیسی Weight of Risk Factors for Adjusting Capitation in Primary Health Care: A Systematic Review
چکیده انگلیسی مقاله Background: Capitation payment is the best-known strategy for paying providers in primary health care. Since health care needs and personal characteristics play an essential role in health care utilization and resource spending, there is a growing tendency on risk adjustment models among health researchers.  The objective of this systematic review was to examine the weights used for risk adjustment in primary health care capitation payment.    Methods: We systematically searched Scopus, ProQuest, Web of Science, and PubMed in March 2018. Two authors independently apprised the included articles and they also evaluated, identified, and categorized different factors on capitation payments mentioned in the included studies.    Results: A total of 742 studies were identified and 12 were included in the systematic review after the screening process. Risk factors for capitation adjustment included age, gender, and income with the weighted average being 1.76 and 1.03, respectively. Moreover, the weighted average disease incidence adjusted clinical groups (ACGs), diagnostic cost groups (DCGs), principal in patient diagnostic cost groups (PIP-DCGs), and hierarchical coexisting conditions (HCCs) were reported as 1.31, 24.7-.99, 10.4-.65, and 11.7-1.01, respectively.    Conclusion: In low-income countries, the most effective factors used in capitation adjustment are age and sex. Moreover, the most applied factor in high-income countries is adjusted clinical groups, and income factors can have a better impact on the reduction of costs in low-income countries. Each country can select its most efficient factors based on the weight of the factor, income level, and geographical condition.
کلیدواژه‌های انگلیسی مقاله Risk Adjustment, Capitation, Risk Factor, Systematic Review, Health Care
نویسندگان مقاله | Ali Khezri
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, & Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Scineces, Tabriz, Iran


| Alireza Mahboub-ahari
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, & Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran


| Jafar Sadegh Tabrizi
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran


| Shirin Nosratnejad
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, & Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
نشانی اینترنتی http://mjiri.iums.ac.ir/browse.php?a_code=A-10-5092-1&slc_lang=en&sid=1
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کد مقاله (doi)
زبان مقاله منتشر شده en
موضوعات مقاله منتشر شده Public Administration & Health management and economics
نوع مقاله منتشر شده Systematic Review
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