Public and private funding of general practice services for children and adolescents in New Zealand.
OBJECTIVE
To measure public and private funding of general practice services for New Zealand children.


METHODS
Computerized records from 111 general practices provided private payments for 118,905 general practice services to children aged 6-17 years. Government subsidies and public insurance payments provided public funding amounts for seven services. Overall and for each service we estimated the ratio of public:private payments (RPPP).


RESULTS
64.0% of annual expenditure was public, 36.0% private, (RPPP=1:0.56). General medical consultations were 67.2% of services (RPPP=1:0.57); 15.3% were injury-related (RPPP=1:0.36); 5.2% were prescribing services (all private); 4.9% were immunizations (RPPP=1:0.12); 2.9% were nursing (RPPP=1:1.33); 4.4% were administration (all private); and 0.1% were for maternity care (RPPP=1:0.007). Before capitation funding, public and private funding levels for general medical consultations were similar (RPPP=1:0.93) but after capitation public payments more than doubled (RPPP=1:0.40).


CONCLUSIONS
There is a complex of pattern of public and private payments for general practice services for children and adolescents in New Zealand. Both funding sources are critical. Capitation funding changed the balance substantially but did not remove ongoing reliance on private funding to support general practice care for children.
Dovey
Susan
S
Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. susan.dovey@otago.ac.nz
Tilyard
Murray
M
Cunningham
Wayne
W
Williamson
Martyn
M
D000293:Adolescent; D002648:Child; D005260:Female; D005380:Financing, Government / Q000191:economics / Q000706:statistics & numerical data*; D058006:General Practice / Q000191:economics*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007114:Immunization / Q000191:economics / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008427:Maternal Health Services / Q000191:economics / Q000706:statistics & numerical data; D009520:New Zealand; D009722:Nurse Practitioners / Q000191:economics / Q000706:statistics & numerical data; D055656:Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D017149:Private Sector / Q000191:economics / Q000706:statistics & numerical data*; D017664:Uncompensated Care / Q000191:economics / Q000706:statistics & numerical data