Will german patients accept their family physician as a gatekeeper?

Himmel, Wolfgang; Dieterich, Anja; Kochen, M. M.

doi:10.1046/j.1525-1497.2000.10016.x

Cited by 24 publications

(28 citation statements)

References 28 publications

(31 reference statements)

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“…2–5 The gatekeeper policy has been widely established in many western countries, such as Germany, 6,7 Spain, 8 the United Kingdom, 9,10 and the Netherlands. 11,12 In the last 5 years, China's healthcare reform has made substantial progress in expansion of the insurance coverage, and strengthening of the infrastructure of primary healthcare facilities.…”

Section: Introductionmentioning

confidence: 99%

Patients’ Willingness on Community Health Centers as Gatekeepers and Associated Factors in Shenzhen, China

Gan

Cao

et al. 2016

Medicine

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The gate-keeping function of primary healthcare facilities has not been fully implemented in China. This study was aiming at assessing the willingness on community health centers (CHCs) as gatekeepers among a sample of patients and investigating the influencing factors.A cross-sectional survey was conducted in 2013. A total of 7761 patients aged 18 to 90 years from 8 CHCs in Shenzhen (China) were interviewed using a structured questionnaire. Descriptive and multivariable logistic regression analyses were used to analyze the characteristics of patients, their willingness on the gatekeeper policy, and identify the associated factors.On willingness of patients to select CHCs as gatekeepers, 70.03% of respondents were willing, 18.95% were neutral, and 9.02% were unwilling. Multivariable analysis indicated that female patients (odds ratio [OR] = 1.15, 95% confidence interval [CI]: 1.02–1.30); patients with health insurance (OR = 1.21, 95% CI: 1.07–1.36); patients who lives near CHC (OR = 1.89, 95% CI: 1.17–3.05); and patients who were more familiar with the gatekeeper policy (OR = 2.09, 95% CI: 1.85–2.36), had higher level of willingness on the policy. Conversely, reporting with good health status was independently associated with the decreased willingness on gatekeeper policy (OR = 0.69, 95% CI: 0.53–0.90).The findings indicated that patients’ willingness on CHCs as gatekeepers is high. More priority measures, such as expanding medical insurance coverage of patients, strengthening the propaganda of gatekeeper policy, and increasing the access to community health service, are warranted to be taken. This will help to further improve the patients’ willingness on CHCs as gatekeepers. It is thus feasible to implement the gatekeeper policy among patients in China.

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Section: Introductionmentioning

confidence: 99%

Patients’ Willingness on Community Health Centers as Gatekeepers and Associated Factors in Shenzhen, China

Gan

Cao

et al. 2016

Medicine

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“…As a result, most people in free access systems see no problems in the development towards gatekeeping. However, a smaller group of the population is dissatisfied with a restricted access to specialists (Himmel et al, 2000;Tai-Seale and Pescosolido, 2003). Gatekeeping models are therefore likely to force especially privileged groups to change their behaviour (Le Fur and Yilmaz, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…In terms of the choice of healthcare provider, evidence indicates the paradoxical situation, that individuals like having choice but choose not to use it (Coulter, 2010;Schlesinger, 2010). With respect to choosing the level of care and gatekeeping restrictions, evidence indicates that most patients appreciate the role of a family physician 1 as the first point of contact and coordinator of care (Berendsen et al, 2009;Grumbach et al, 1999;Himmel et al, 2000). However, in countries with a long tradition of free choice of doctors, restricting access to secondary care through gatekeeping can result in dissatisfaction.…”

Section: Patient Empowerment and Patient Satisfactionmentioning

confidence: 99%

Gatekeeping and provider choice in OECD healthcare systems

Reibling

Wendt

2012

Current Sociology

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Gatekeeping and provider choice have become central in health policymaking within the last two decades. This article contributes to the debates in two ways: first, it provides an extended review of evidence on the impact of gatekeeping and provider choice on efficiency, costs, quality, equality and patient empowerment; and second, it empirically analyses regulations and identifies common trends in healthcare reforms in OECD countries since 1990. More than half of the countries analysed have established gatekeeping systems, while a smaller number provides free access to secondary care. The study discovers a trend towards strengthening gatekeeping regulations within free access countries. Free choice of provider is the standard in the OECD, where only a small number of countries restrict provider choice. The article identifies a diverging trend of reforms, with some traditionally restrictive countries offering more provider choice and other countries limiting the choice of providers as a result of managed care reforms.

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“…Delnoij and Brenner (2000) note that the use of GPs as gatekeepers is inherently difficult if, as is the case in Germany at present, there are multiple payers. An interesting recent study suggests, however, that there would be strong support among Germans for the use of family physicians as gatekeepers -perhaps as a consequence of the complexities of choice of care provider that they face under current arrangements (Himmel, Dieterich, and Kochen, 2000).…”

Section: Current Methods Of Health Care Financing In Germanymentioning

confidence: 99%