[General practitioner-centred health-care in Germany. The general practitioner as gatekeeper]

In many countries, the gatekeeper system in health care has been existent for several years. The health reform 2004 has strengthened the position of the general practitioner (GP) in German health care. The introduction of the so-called general practitioner programmes (Hausarztprogramme) represents a new form of health care. The GP is credited with a gate-keeping function. The aim of GP-centred care is to avoid expensive double check-ups and specialist consultations which are not necessary from a medical point of view. Optimisation and co-operation of people and institutions within the health care system are also intended. The GP programme offers advantages for both parties. The position of the GPs is being strengthened. For example, the insured have fewer expenses, shorter waiting times at the GP practice and benefit of the co-ordination of more complex treatments by the GP. Regarding this topic, a postal survey with members of a compulsory health insurance fund interviewed 962 participants of a GP programme and 644 non-participants (control group). The study's results show that the GP's gatekeeper function is accepted by most of the insured, but that there is still a need to optimise the daily implementation of GP-centred care.