ACCEPTABILITY TO GENERAL-PRACTITIONERS OF NATIONAL-HEALTH INSURANCE AND CAPITATION AS A REIMBURSEMENT MECHANISM

Objective. To determine general practitioners' attitudes to national h ealth insurance (NHI) and to capitation as a mechanism of reimbursemen t. To explore determinants of these attitudes. Design. Cross-sectional survey by means of telephone interviews; four focus group discussions . Setting. Cape Peninsula. Participants. 174 GPs randomly sampled from a total population of 874. Main outcome measures. Acceptance of NHI, acceptance of capitation. Main results. 63,3% approved of NHI, More th an 81% approved of NHI if GPs would be able to maintain their independ ent status, e.g. own premises and working hours; 82,3% said NHI would be a more equitable system of health care, 88% approved of the fact th at NHI would make care by GPs more accessible, and 73% said they would have the capacity to treat more patients, However, 61,3% of GPs disap proved of capitation as a form of reimbursement. Conclusions. Most GPs in the Cape Peninsula were amenable to some form of NHI. However, the proportion of GPs who approved the introduction of NHI varied dependi ng on details of the NHI system such as payment mechanisms, workload, income and effects on professional autonomy. A national survey of medi cal practitioners is recommended. The implications of GPs' preferences concerning the reimbursement mechanism for the feasibility of impleme nting a NHI system in South Africa require serious consideration by po licy-makers.