The gatekeeper effect on managing acute medical conditions.
This study was designed to analyze whether the gatekeeper approach, by itself, is effective in changing physicians' practice patterns. The effect of the gatekeeper could be isolated, because a 95% overlap existed between contracted physicians in the PPO plan and the POS plan used in the study. In treating low-to-moderately resource-intensive conditions, the results of this episode-of-care study showed that the POS system of care (gate-keeper in place) was no more efficient than the PPO system of care (no gatekeeper mechanism) in terms of overall medical costs.
Anderson
S
S
Practice Patterns Science, Maryland Heights, MO 63141, USA.
Cave
D
D
D000208:Acute Disease; D000553:Ambulatory Care / Q000191:economics; D002140:California; D017050:Episode of Care; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data; D017722:Hospital Charges; D006801:Humans; D010818:Practice Patterns, Physicians'; D011243:Preferred Provider Organizations; D012017:Referral and Consultation