title: [Impact of a capitation payment system on healthcare coordination].
abstract: OBJECTIVE
  To evaluate the impact of the catalan pilot project of capitation payment on healthcare coordination from a qualitative perspective.
  
  
  METHODS
  An exploratory, descriptive, qualitative study was carried out by means of document analysis and individual interviews. A criterion sample of documents and of informants was selected: purchasers (9) and providers (26) managers, and health professionals (16). A content analysis was conducted, with mixed generation of categories and data segmentation by informants' groups, themes, and areas. The study area consisted of the 5 pilot zones.
  
  
  RESULTS
  According to the informants, the pilot test facilitated a shared vision of the area and improved communication among providers. Nevertheless, changes introduced as a consequence of the project to improve healthcare coordination were scarce. A virtual alliance among providers with shared objectives and structural changes was found in just one area. Healthcare coordination mechanisms were exchanged, with variable use. Perceived barriers to change were uncertainty, providers' fears of losing their identity, lack of interest, and the management limits of some providers.
  
  
  CONCLUSIONS
  The designed and implemented capitation payment system failed to generate enough incentives to stimulate changes in healthcare coordination. The weaknesses identified by this evaluation should be resolved before extending the pilot project to the rest of Catalonia.
authors.affiliation: Servei d'Estudis i Prospectives en Polítiques de Salut, Consorci Hospitalari de Catalunya, Barcelona, España.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vargas Lorenzo
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Vázquez Navarrete
authors.forename: Rebeca
authors.initials: R
authors.lastname: Terraza Núñez
authors.forename: Enric
authors.initials: E
authors.lastname: Agustí
authors.forename: Francesc
authors.initials: F
authors.lastname: Brosa
authors.forename: Carme
authors.initials: C
authors.lastname: Casas
mesh_terms: D002204:Capitation Fee; D003695:Delivery of Health Care / Q000458:organization & administration*; D012051:Reimbursement Mechanisms; D013030:Spain