Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Primary care gatekeepers in HMOs.

R F Catlin, R C Bradbury, R J Catlin

    The Journal of Family Practice
    |October 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Primary care physicians may reduce health care costs by managing referrals and tests. This study found higher ambulatory care use in staff health maintenance organizations (HMOs) but no significant difference in hospital use based on primary care physician numbers.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Comparing uninsured and privately insured hospital patients: admission severity, health outcomes and resource use.

    Health services management research·2001
    Same author

    Linking health outcomes and resource efficiency for hospitalized patients: do physicians with low mortality and morbidity rates also have low resource expenditures?

    Health services management research·2001
    Same author

    A comparison of hospital utilization by Medicaid and privately insured patients.

    Medical care research and review : MCRR·1998
    Same author

    Toward a systems quality paradigm: relating health outcomes, resource expenditures, and appropriateness of cholecystectomy patients.

    Health services management research·1997
    Same author

    An integrative role for a health policy course in the health services management graduate curriculum.

    The Journal of health administration education·1997
    Same author

    Occurrence of validating clinical findings in the hospital record for appendectomy, cholecystectomy and intervertebral disc excision patients: comparisons among hospitals and among surgeons.

    Health services management research·1996

    Area of Science:

    • Health Services Research
    • Health Economics
    • Primary Care Medicine

    Background:

    • Rising healthcare costs are a major concern in health care delivery.
    • Primary care physicians, particularly family physicians, may act as gatekeepers to control costs.
    • Health Maintenance Organizations (HMOs) offer a suitable setting to study this gatekeeping effect due to defined patient populations.

    Purpose of the Study:

    • To investigate the impact of primary care physician gatekeeping on healthcare utilization and costs within HMOs.
    • To determine if HMO internal organization influences hospital and ambulatory care utilization.
    • To explore the relationship between the number of primary care physicians and healthcare utilization rates.

    Main Methods:

    • Analysis of healthcare utilization data within a defined population of HMOs.

    Related Experiment Videos

  • Comparison of hospital and ambulatory care utilization rates across different HMO organizational structures.
  • Examination of the correlation between the number of primary care physicians and utilization rates.

    • Main Results:

    • HMO internal organization did not significantly affect hospital or ambulatory care utilization, except for staff HMOs showing higher ambulatory care use.
    • No significant differences in hospital or ambulatory care utilization were found based on the proportion of primary care physicians or family physicians.
    • Ambulatory care utilization was proportional to the total number of physicians per 1,000 members.
    • A potential inverse relationship was observed between hospital utilization and the number of primary care physicians, especially family physicians.

    Conclusions:

    • The study suggests a potential inverse relationship between the number of primary care physicians, particularly family physicians, and hospital utilization rates.
    • Ambulatory care utilization appears to be driven by the overall physician density within an HMO.
    • Further research with more specific indicators is needed to fully evaluate the cost-saving gatekeeping role of primary care physicians.