New Findings from R. Tandjung and Co-Authors in the Area of Managed Care Reported (Referral determinants in Swiss primary care with a special focus…
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Our news editors obtained a quote from the research, "In Switzerland no mandatory gatekeeping system exists, however insurance companies offer voluntary managed care plans with reduced insurance premiums. We aimed at investigating the role of managed care plans as a potential referral determinant in a non-gatekeeping healthcare system. We conducted a cross-sectional study with 90 PCPs collecting data on consultations and referrals in 2012/2013. During each consultation up to six reasons for encounters (RFE) were documented. For each RFE PCPs indicated whether a referral was initiated. Determinants for referrals were analyzed by hierarchical logistic regression, taking the potential cluster effect of the PCP into account. To further investigate the independent association of the managed care plan with the referral probability, a hierarchical multivariate logistic regression model was applied, taking into account all available data potentially affecting the referring decision. PCPs collected data on 24'774 patients with 42'890 RFE, of which 2427 led to a referral. 37.5% of patients were insured in managed health care plans. Univariate analysis showed significant higher referral rates of patients with managed care plans (10.7% vs. 8.5%). The difference in referral probability remained significant after controlling for other confounders in the hierarchical multivariate regression model (OR 1.355). Patients in managed care plans were more likely to be referred than patients without such a model."
According to the news editors, the research concluded: "These data contradict the argument that patients in managed care plans have limited healthcare access, but underline the central role of PCPs as coordinator of care."
For more information on this research see: Referral determinants in Swiss primary care with a special focus on managed care. Plos One, 2017;12(11):e0186307. (
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The direct object identifier (DOI) for that additional information is: https://doi.org/10.1371/journal.pone.0186307. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.
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