Direct Primary Care: Concierge Care For The Masses

Huff, Charlotte

doi:10.1377/hlthaff.2015.1281

Cited by 14 publications

(14 citation statements)

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“…18,19 At the same time, more physicians, particularly those providing primary care, are considering or have moved into concierge practice in response to treatment time constraints and work effort-compensation concerns. 20,21 In light of structural changes in the physician labor market, we report on a national survey of practicing physicians that assessed their perceptions of pay fairness. Specifically, we hypothesized that physicians who think their compensation is fair will be more satisfied at work, be less inclined to leave their medical practice, and report having better overall health.…”

Section: Introductionmentioning

confidence: 99%

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health

et al. 2018

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“…Although GPs do not fulfill a formal compulsory gatekeeper function in Germany, their availability and accessibility play a crucial role in a populations’ access to health care [6, 37]. Hence, it can be assumed that an unbalanced distribution of GPs could translate into health inequities [38, 39].…”

Section: Discussionmentioning

confidence: 99%

General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status

Bauer

Brueggmann

Ohlendorf

et al. 2016

BMC Health Serv Res

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BackgroundGeographical variation of the general practitioner (GP) workforce is known between rural and urban areas. However, data about the variation between and within urban areas are lacking.MethodWe analyzed distribution patterns of GP full time equivalents (FTE) in German cities with a population size of more than 500,000. We correlated their distribution with area measures of social deprivation in order to analyze preferences within neighborhood characteristics. For this purpose, we developed two area measures of deprivation: Geodemographic Index (GDI) and Cultureeconomic Index (CEI).ResultsIn total n = 9034.75 FTE were included in n = 14 cities with n = 171 districts. FTE were distributed equally on inter-city level (mean: 6.49; range: 5.12–7.20; SD: 0.51). However, on intra-city level, GP distribution was skewed (mean: 6.54; range: 1.80–43.98; SD: 3.62). Distribution patterns of FTE per 10^4 residents were significantly correlated with GDI (r = −0.49; p < 0.001) and CEI (r = −0.22; p = 0.005). Therefore, location choices of GPs were mainly positively correlated with 1) central location (r = −0.50; p < 0.001), 2) small household size of population (r = −0.50; p < 0.001) and 3) population density (r = 0.35; p < 0.001).ConclusionIntra-city distribution of GPs was skewed, which could affect the equality of access for the urban population. Furthermore, health services planners should be aware of GP location preferences. This could be helpful to better understand and plan delivery of health services. Within this process the presented Geodemographic Index (GDI) could be of use.

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“…Conversely, membership fees affect accessibility as a barrier to those unable or unwilling to make monthly payments for primary care. Many physicians who practice in DPC models have argued that it is incorrect to assume that the remaining eligible population is systematically less vulnerable both physically and financially 5,[15][16][17][18] ; however, the assertion that DPC patients are representative of the socioeconomic and health status of a given community has not been demonstrated. For example, Alexander and col- …”

Section: Structurementioning

confidence: 99%

“…3,5 By one count, there are currently at least 723 DPC practice locations in 48 states. 6 A survey conducted by the American Academy of Family Practice found that 2% of respondents reported practicing in a DPC model, with another 7% considering a move to DPC in the future.…”

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confidence: 99%

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Direct Primary Care: Applying Theory to Potential Changes in Delivery and Outcomes

Cole

2018

J Am Board Fam Med

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Direct Primary Care (DPC), where patients pay a fee to a primary care provider to obtain access to services, is a delivery model that has received notable attention and enthusiasm from some providers. Proponents of DPC believe that the model increases accessibility, reduces overhead, and ultimately improves care for patients; however, there is little evidence in the peer-reviewed literature to support these claims. The objective of this analysis was to apply Starfield's adaptation of Donabedian's Structure-Process-Outcome conceptual model to evaluate primary care to formally display the links between potential changes in clinical structure and processes from DPC adoption. Based on existing literature on the constructs in Starfield's model, expectations of DPC's impact at the patient, clinic, and system levels were defined. DPC uses changes to financing and the population eligible to trigger potential gains in continuity and accessibility to subsequently improve care processes. There is evidence to support DPC as a theoretically sound approach to improve attributes of primary care, such as first contact care and longitudinality at the clinic level for participating patients. At the health system level, DPC has low-construct validity that would suggest a positive impact on the potentially eligible population's health due to membership fees that exclude patients who are more likely to be vulnerable and complex than patients who are willing and able to stay in the practice. Descriptive and comparative research of included and excluded patients is needed to inform providers, patients, and policy makers of the DPC's ability to attain the attributes of primary care and ultimately achieve better outcomes over alternative primary care delivery and financing models.

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Direct Primary Care: Concierge Care For The Masses

Cited by 14 publications

References 1 publication

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health

Physician Perception of Pay Fairness and its Association with Work Satisfaction, Intent to Leave Practice, and Personal Health

General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status

Direct Primary Care: Applying Theory to Potential Changes in Delivery and Outcomes

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