Title:
EFFECT OF NUMBER OF MEMBERS CAPITATED TO A HEALTHCARE PROVIDER ON EFFECTIVE HEALTH SERVICE DELIVERY UNDER CAPITATION CONTRACTING IN KENYA

Authors:
Priscilla Wangai , Amos Njuguna and Joseph Ngugi

Abstract:
This study documents the effect of number of members capitated to a health provider on effective health service delivered under capitation contracting in Kenya. In the Kenyan capitation model, there is no maximum or minimum number that is assigned to health providers. Accordingly the number of capitated members to a provider depends on the members’ preference. A closed ended questionnaire was used to collect data from a sample of 297 healthcare providers practicing capitation. Logit regression analysis on the data revealed that healthcare providers who experienced congestion were 0.036 less likely to deliver quality healthcare , but 1.349 and 1.300 more likely to be accessible and affordable respectively. In addition, an increase in the number of members capitated by one unit would lead to 0.279 decrease on quality, but 1.547 and 1.359 increase in accessibility and affordability respectively. Further, an increase in the number of consultations by the most frequent member by one unit would lead to 0.173 decrease on quality, but 1.105 and 1.295 increase in accessibility and affordability respectively. From these findings, we recommend that members should be assigned to healthcare providers based on the providers’ capability with a gate keeping fee to limit unnecessary visits.