From GP list size to practice configurations A quantitative study protocole

PURPOSE : How many patients can a GP practice handle? List size is analysed through international literature, but comparison is difficult. Practices have different designs and configurations and described from solo practices to multiprofessional teams. Health services provided may vary in a wide range (curative care, palliative care, health promotion, prevention, gynaecology, paediatrics, technical interventions…). The patients’ morbidity can influence the workload and therefore list-size and also the most appropriate team to meet the needs.
THEORY : Belgium provides freedom of choice to organise practices and there is no constraints for list-size. There are three payment methods for primary care professionals: fee-for-service, capitation-fee, and third mixed option in a pilot phase. The exact number of patients a GP list is not easy to assess in fee-for-service practices and the third option still must be developed. At the opposite in capitated PC practices (CF-PCP), patients must register with the practice which automatically implies a list of patients, and there is a minimum configuration of professionals including at least GPs, a nurse or a physiotherapist and a receptionist. Thus, list-size and configuration of these practices can be determined.
METHODS : Data will be collected for each CF-PCP with a focus on 1) patient list size 2) number and profile of professionals in the practice 3) Full-time and part-time equivalents 4) number of years the practice is active and 5) morbidity indicators. A multivariate regression analysis could be proposed depending on morbidity indicators we can collect, dependent variables being list-size and practice configurations.
EXPECTED RESULTS :
1. descriptive analysis of these spontaneous CF-PCP
2. explaining factors for diversity of practice list-size and configurations