Substitution of primary care and specialist care: a regional analysis in Denmark.

A debate is going on in health care systems with capitation payment for general practitioner services about the disincentives of the system, leading to a low level of interventions by GPs and a high level of referrals. Increasing the fee-for-service element in the remuneration of GPs is seen as the remedy. A mixed system of fee for service and capitation exists in Denmark. The fee for service part generates administrative data on the number of services. These data have been analysed at province level to find out whether or not a greater number of services by GPs in a province coincides with a lower level of hospital and specialist care. It proves that in provinces with a greater number of services by GPs the number of ambulatory hospital visits is smaller.