Privatised family group practices in Mongolia: an initial assessment of service access

Abstract

Mongolia is changing the way that primary care is delivered, by replacing salaried government staff with private family group practices (FGPs) paid by risk-adjusted capitation. As part of a mid-project evaluation, we surveyed a sample of FGPs in order to assess the patterns of access to care. We found that generally satisfactory services are being provided in an equitable way, and therefore that the main goals of the new model are being achieved. However, there are some concerns. Inter alia, we argue that more should be done to establish better standards of clinical practice through the distribution of protocols and illustrative pathways, and to increase the extent to which services are organised in a manner that is sensitive to informed consumers' needs. A design limitation meant that few baseline data were available, and the survey will need to be repeated if valid conclusions are to be drawn.