[Capitation contract financing of primary health care: a possible alternative to traditional payment for service--part 1].

Worldwide health systems are faced with additive and complex problems: a cost containment willingness, growing expenses for the health care budgets particularly in relation with the new technologies, questioning about true quality of provided care from results indicators. Health care financing is one of the major determinants of the nature and the comprehensive quality of the system: its aim to promote suitable processes and behaviors, to dissuade inadequate ones, in a context of efficiency (efficacy with minimal cost), as for politic decidors, as for the patients, as for the providers, as for the insurers/funders. A comparative and critical approach of the international scientific literature shows that partial fixed capitation payment is an interesting alternative for the total fee for service. Taking into account many experiences, a proposal for a cumulated financing for the practices is made: a structural part, a fixed capitation payment (the most important), a fee for service one, a target payment one, and a patient personal participation.