Risk and the GP budget holder

Abstract

For most individuals, the use made of health care in a given year is determined principally by unpredictable random incidents. Of course, some individuals have a predictably higher predisposition to illness than others. However, the general consensus is that only a fraction of individual variability in health care costs can be predicted. The purpose of this paper is to explore the implications of this inherent randomness for budget setting for GP purchasers. The paper argues that variability in utilization in the NHS is very high; that no formula will ever completely capture that variability, even for large populations; that the problem of variability is likely to be very acute for a GP practice; and that health authorities and GP budget holders will therefore need to adopt a range of strategies to manage the variability.fundholding