7,840
Views
82
CrossRef citations to date
0
Altmetric
Research Article

The effects of gatekeeping: A systematic review of the literature

, &
Pages 28-38 | Received 22 Mar 2010, Accepted 27 Sep 2010, Published online: 30 Dec 2010

References

  • Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q 2005;83:457–502.
  • Delnoij D, van Merode G, Paulus A, . Does general practitioner gatekeeping curb health care expenditure? J Health Serv Res Policy 2000;5:22–6.
  • Franks P, Clancy CM, Nutting PA. Gatekeeping revisited, protecting patients from overtreatment. N Engl J Med 1992;327:424–9.
  • Cooper PF, Simon KI, Vistnes J. A closer look at the managed care backlash. Med Care 2006;44:I–4–I–11.
  • Fang H, Liu H, Rizzo JA. Has the use of physician gatekeepers declined among HMOs? Evidence from the United States. Int J Health Care Finance Econ 2009;9:183–95.
  • Cochrane Effective Practice and Organization of Care Group (EPOC). EPOC resources for review authors. http://www.epoc.cochrane.org/en/handsearchers.html (last accessed May 25, 2009).
  • Briss PA, Zaza S, Pappaioanou M, . Developing an evidence-based guide to community preventive services – methods. Am J Prev Med 2000;18:35–43.
  • Harris RP, Helfand M, Woolf SH, . Current methods of the US Preventive Services Task Force: A review of the process. Am J Prev Med 2001;20:21–35.
  • Miller RH, Luft HS. Managed care plan performance since 1980: A literature analysis. JAMA 1994;271:1512–9.
  • Etter JF, Perneger TV. Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan. J Epidemiol Community Health 1998;52:370–6.
  • Etter JF, Perneger TV. Introducing managed care in Switzerland: Impact on use of health services. Public Health 1997;111:417–22.
  • Perneger TV, Etter JF, Rougemont A. Switching Swiss enrollees from indemnity health insurance to managed care: The effect on health status and satisfaction with care. Am J Public Health 1996;86:388–93.
  • Schwenkglenks M, Preiswerk G, Lehner R, . Economic efficiency of gate-keeping compared with fee for service plans: A Swiss example. J Epidemiol Community Health 2006;60:24–30.
  • Werblow A. [Efficiency of general practice in Switzerland]. Gesundheitswesen 2005;67:107–11.
  • Olivarius ND, Jensen FI, Gannik D; . Self-referral and self-payment in Danish primary care. Health Policy 1994;28:15–22.
  • Ose D, Broge B, Riens B, Szecsenyi. Mit Überweisung vm Hausarzt zum Spezialisten – Haben Verträge zur Hausarztzentrierten Versorgung (HZV) einen Einfluss? [Contacts with specialists with referrals by GP – Do GP Centred Health Care (HZV) contracts have an impact?] (English summary). Z Allg Med 2008;84:321–6.
  • Holdsworth LK, Webster VS, McFadyen AK, and the Scottish Physiotherapy Self-Referral Study Group. Are patients who refer themselves to physiotherapy different from those referred by GPs? Results of a national trial. Physiotherapy 2006;92:26–33.
  • Holdsworth LK, Webster VS, McFadyen AK and the Scottish Physiotherapy Self-Referral Study Group. Self referral to physiotherapy: Deprivation and geographical setting: is there a relationship? Results of a national trial. Physiotherapy 2006;92:16–25.
  • Holdsworth LK, Webster VS, McFadyen AK, on behalf of the Scottish Physiotherapy Self-Referral Study Group. What are the costs to NHS Scotland of selfreferral to physiotherapy? Results of a national trial. Physiotherapy 2007;93:3–11.
  • Webster VS, Holdsworth LK, McFayden AK, Little H. Self-referral, access and physiotherapy: Patients’ knowledge and attitudes – results of a national trial. Physiotherapy 2008;94:141–9.
  • Leemrijse CJ, Swinkels ICS, Veenhof C. Direct access to physical therapy in the Netherlands: Results from the first year in community-based physical therapy. Phys Ther 2008;88:936–46.
  • Linden M, Gothe H, Ormel J. Pathways to care and psychological problems of general practice patients in a “gate keeper” and an “open access” health care system: a comparison of Germany and the Netherlands. Soc Psychiatry Psychiatr Epidemiol 2003;38:690–7.
  • Anderson S, Cave D. The gatekeeper effect on managing acute medical conditions. Med Interface 1996;9:122–9.
  • Escarce JJ, Kapur K, Joyce GF, . Medical care expenditures under gatekeeper and point-of-service arrangements. Health Serv Res 2001;36:1037–57.
  • Joyce GF, Kapur K, Van Vorst KA, . Visits to primary care physicians and to specialists under gatekeeper and point-of-service arrangements. Am J Manag Care 2000;6:1189–96.
  • Kapur K, Joyce GF, Van Vorst KA, . Expenditures for physician services under alternative models of managed care. Med Care Res Rev 2000;57:161–81.
  • Ferris TG, Chang Y, Blumenthal D, . Leaving gatekeeping behind: Effects of opening access to specialists for adults in a health maintenance organization. N Engl J Med 2001;345:1312–7.
  • Ferris TG, Chang Y, Perrin JM, . Effects of removing gatekeeping on specialist utilisation by children in a health maintenance organization. Arch Pediatr Adolesc Med 2002;156:574–9.
  • Ferris TG, Perrin JM, Manganello JA, . Switching to gatekeeping: Changes in expenditures and utilisation for children. Pediatrics 2001;108:283–90.
  • Martin DP, Diehr P, Price KF, . Effect of a gatekeeper plan on health services use and charges: A randomized trial. Am J Public Health 1989;79:1628–32.
  • Meyer TJ, Prochazka AV, Hannaford M, . Randomized controlled trial of residents as gatekeepers. Arch Intern Med 1996;156:2483–7.
  • Paone GH, Higgins RS, Spencer T, . Enrollment in the health alliance plan: HMO is not an independent risk factor for coronary artery bypass graft surgery. Circulation 1995;92:II69–72.
  • Rask KJ, Deaton C, Culler SD, . The effect of primary care gatekeepers on the management of patients with chest pain. Am J Manag Care 1999;5:1274–82.
  • Schillinger D, Bibbins-Domingo K, Vranizan K, . Effects of primary care coordination on public hospital patients. J Gen Intern Med 2000;15:329–36.
  • Swetter SM, Soon S, Harrington CR, . Effect of health care delivery models on melanoma thickness and stage in a university-based referral center: An observational pilot study. Arch Dermatol 2007;143:30–6.
  • Hurley RE, Freund DA, Taylor DE. Gatekeeping the emergency department: Impact of a Medicaid primary care case management program. Health Care Manage Rev 1989;14:63–71.
  • Hurley RE, Freund DA, Taylor DE. Emergency room use and primary care case management: Evidence from four Medicaid demonstration programs. Am J Public Health 1989;79:843–6.
  • Hurley RE, Freund DA, Gage BJ. Gatekeeper effects on patterns of physician use. J Fam Pract 1991;32:167–74.
  • Laditka SB, Laditka JN. Utilization, costs, and access to primary care in fee-for-service and managed care plans. J Health Soc Policy 2001;13:21–39.
  • Shatin D, Levin R, Ireys HT, . Health care utilisation by children with chronic illnesses: A comparison of Medicaid and employer insured managed care. Pediatrics 1998;102: E44.
  • Forrest CB, Glade GB, Starfield B, . Gatekeeping and referral of children and adolescents to specialty care. Pediatrics 1999;104:28–34.
  • Willems D, Veldhuis M. Vormen van selectie aab de poort en hun effecten. Eenliteratuuronderzoek [Does the gatekeeper enhance appropriateness of care? A literature study] (English summary). Huisarts Wet 2004;47:625–30.
  • Engström S, Foldevi M, Borgquist L. Is general practice effective? A systematic literature review. Scand J Prim Health Care 2001;19:131–44.
  • Zentner A, Velasco Garrido M, Busse R. Macht der Hausarzt als Lotse die Gesundheitsversorgung wirklich besser und billiger? Ein systematischer Review zum Konzept Gatekeeping [Do primary care physicians acting as gatekeepers improve health outcomes and decrease costs? A systematic review of the concept of gatekeeping] (English summary). Das Gesundheitswesen 2010;72:e38–e44 (DOI: 10.1055/s-0029-1234126).