Visits to primary care physicians and to specialists under gatekeeper and point-of-service arrangements

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dc.contributor.author Kapur, Kanika
dc.contributor.author Joyce, Geoffrey F.
dc.contributor.author Escarce, José J.
dc.contributor.author Van Vorst, Krista A.
dc.date.accessioned 2008-06-30T15:54:24Z
dc.date.available 2008-06-30T15:54:24Z
dc.date.copyright Copyright 2000 Medical World Communications, Inc en
dc.date.issued 2000
dc.identifier.citation American Journal of Managed Care en
dc.identifier.issn 1088-0224
dc.identifier.uri http://hdl.handle.net/10197/278
dc.description.abstract Objective: To assess utilization of ambulatory visits to primary care physicians (PCPs) and to specialists in 2 different managed care models: a closed panel gatekeeper health maintenance organization (HMO) and an open panel point-of-service HMO. Study Design: Retrospective study of patients enrolled in a single managed care organization with 2 distinct product lines: a gatekeeper HMO and a point-of-service HMO. Both plans shared the same physician network. Patients and Methods: The study sample included 16,192 working-age members of the gatekeeper HMO and 36,819 working-age members of the point-of-service HMO. We estimated the number of PCP and specialist visits using negative binomial regression models and predicted the number of visits per year for each person under each HMO type and copayment option. Results: There were more annual visits to PCPs and a greater number of total physician visits in the gatekeeper HMO than in the point-of-service plan. However, we did not observe higher rates of specialist visits in the point-of-service HMO. Conclusion: We found no evidence that direct patient access to specialists leads to higher rates of specialty visits in plans with modest cost-sharing arrangements. en
dc.format.extent 4640 bytes
dc.format.mimetype application/pdf
dc.language.iso en en
dc.publisher Mwc Medical World Communications, Inc en
dc.rights.uri Publisher's copyright details en
dc.rights.uri http://www.ajmc.com/article.cfm?StoryID=10 en
dc.subject.lcsh Managed care plans (Medical care) en
dc.subject.lcsh Ambulatory medical care--Utilization en
dc.subject.lcsh Health services accessibility en
dc.title Visits to primary care physicians and to specialists under gatekeeper and point-of-service arrangements en
dc.type Journal Article en
dc.internal.authorurl Kanika Kapur (web page) en
dc.internal.authorurl http://www.ucd.ie/economics/staff/kkapur/kanika.kapur.htm en
dc.internal.authorcontactother Email: kanika.kapur@ucd.ie; Tel: 353 1 716 4624 en
dc.internal.authorid UCD0012 en
dc.internal.availability Full text available en
dc.internal.webversions Publisher's version en
dc.internal.webversions http://www.ajmc.com/files/articlefiles/AJMC2000novJoyce1189_1196.pdf en
dc.status Peer reviewed en
dc.identifier.volume 6 en
dc.identifier.issue 11 en
dc.identifier.startpage 1189 en
dc.identifier.endpage 1196 en
dc.neeo.contributor Van Vorst|Krista A.|aut|
dc.neeo.contributor Escarce|José J.|aut|
dc.neeo.contributor Joyce|Geoffrey F.|aut|
dc.neeo.contributor Kapur|Kanika|aut|UCD0012


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