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Related Concept Videos

Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Primary Healthcare Services01:30

Primary Healthcare Services

Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
Introduction To Health Care Delivery System01:18

Introduction To Health Care Delivery System

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Preventive Healthcare Services01:30

Preventive Healthcare Services

Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Patient-centered Care01:13

Patient-centered Care

Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...

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Related Experiment Video

Updated: Jun 19, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

[Do primary care physicians acting as gatekeepers really improve health outcomes and decrease costs? A systematic

A Zentner1, M Velasco Garrido, R Busse

  • 1Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin. annette.zentner@tu-berlin.de

Gesundheitswesen (Bundesverband Der Arzte Des Offentlichen Gesundheitsdienstes (Germany))
|October 2, 2009
PubMed
Summary

Primary care physicians (PCP) gatekeeping reduces specialist care use and healthcare costs. Health outcomes may be comparable to open access, but evidence quality is limited.

Related Experiment Videos

Last Updated: Jun 19, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Health Economics

Background:

  • Gatekeeping by primary care physicians (PCP) is a strategy to manage access to specialist care.
  • The effectiveness and impact of gatekeeping on various healthcare outcomes require systematic evaluation.

Purpose of the Study:

  • To systematically review the effects of PCP gatekeeping on specialist care access.
  • To analyze impacts on health outcomes, quality of life, care utilization, costs, and patient/provider satisfaction.

Main Methods:

  • Comprehensive literature search across multiple databases (Medline, EMBASE, Cochrane Library) and hand searches.
  • Inclusion of diverse study designs (RCTs, cohort studies, controlled before-after studies, interrupted time series).
  • Data extraction and quality assessment by two independent reviewers.

Main Results:

  • 24 studies (1989-2007) from various countries, predominantly the USA, were included.
  • 13 studies reported positive effects of gatekeeping, 2 negative, and 9 showed no difference.
  • Gatekeeping was associated with decreased specialist care utilization and lower healthcare costs.

Conclusions:

  • International evidence on gatekeeping is limited by study quality and applicability.
  • PCP gatekeeping appears to reduce specialist utilization and costs.
  • Health outcomes and quality of life may be comparable to open access, but evidence is limited and inconsistent for other parameters.