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Related Experiment Videos

Are gatekeepers necessary?

L K Brunner1, M M McKnight

  • 1Lovelace Health Systems, Albuquerque, NM, USA.

Best Practices and Benchmarking in Healthcare : a Practical Journal for Clinical and Management Application
|March 1, 1997
PubMed
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Primary care physicians acting as gatekeepers aim to control healthcare costs, but their success is hard to measure due to data limitations. This study proposes methods for future research and emphasizes data sharing to improve healthcare delivery.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Health Economics

Background:

  • Primary care physicians (PCPs) are increasingly utilized as gatekeepers to manage escalating healthcare expenditures.
  • The effectiveness of the gatekeeper model in controlling costs is challenging to quantify due to insufficient data.
  • Current healthcare systems face challenges in measuring the impact of gatekeeping strategies on cost containment and patient outcomes.

Purpose of the Study:

  • To delineate the functional role of primary care physicians as gatekeepers in healthcare systems.
  • To identify and address the complexities and limitations in measuring the benefits derived from gatekeeper interventions.
  • To propose robust methodologies for future research endeavors aimed at evaluating gatekeeper efficacy and to advocate for enhanced data sharing.

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Main Methods:

  • This article presents a conceptual framework and literature review.
  • It outlines the challenges in data collection and analysis pertinent to gatekeeper performance.
  • Proposes a roadmap for future research, emphasizing inter-organizational data collaboration.

Main Results:

  • The study highlights significant data gaps hindering the accurate assessment of gatekeeper effectiveness.
  • Identifies key barriers to measuring cost savings and quality improvements associated with gatekeeping.
  • Underscores the critical need for standardized data collection and sharing protocols.

Conclusions:

  • The successful implementation and evaluation of the primary care gatekeeper model are contingent upon overcoming data scarcity and promoting inter-organizational data sharing.
  • Further research is essential to establish evidence-based guidelines for gatekeeper functions and to optimize healthcare resource allocation.
  • Fostering a collaborative data environment is crucial for advancing the understanding and efficiency of healthcare delivery systems.