The influence of general practitioners on access points to health care in a system without gatekeeping: a cross-sectional study in the context of the QUALICOPC project in Austria

Hoffmann, Kathryn; George, Aaron; Loenen, Tessa van; Maeseneer, Jan De; Maier, Martin

doi:10.3325/cmj.2019.60.316

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Many of our findings on social support and information of the affected person are related to the GP. This is consistent with Hoffmann et al, who described that individuals with a chronic condition visit the GP more often than persons without chronic conditions [36]. Patients with longstanding illness (including oncological diseases) rely on the GP for prescribing pain medication, organizing treatment appointments, or general health-related recommendations.…”

Section: Discussionsupporting

confidence: 87%

Patients’ perception of changes and consequences after tumor resection

Trost

Heisinger

Funovics

et al. 2023

Wien Klin Wochenschr

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Summary Objective The aim of this study was to investigate the effects and consequences of surgical treatment of patients with musculoskeletal malignancies on everyday life. Methods A modified form of grounded theory was used for data collection and analysis. Data collection was systematic and analyzed simultaneously and 16 interviews were conducted: 2 narrative, 11 guided and 3 expert interviews (surgeon, physical therapist, support group). Data collection and analysis alternated until no new codes could be found. Once theoretical saturation was achieved, the main category was formed and described using the literature. Results The main category results from the combination of all categories and leads to the core category. In the center is the affected person and in the immediate environment are the patient’s relatives/partners. In the next instance the primary care physician is necessary to establish a sense of normalcy. This depends on the individuality of the person and the restored possibilities of movement. Conclusion Based on the results, the necessity of implementing psychosocial care involving the social environment is shown. The importance of relatives/partners for recovery is emphasized. Furthermore, the communication between the specialists and family physicians should be simplified.

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Section: Discussionsupporting

confidence: 87%

Patients’ perception of changes and consequences after tumor resection

Trost

Heisinger

Funovics

et al. 2023

Wien Klin Wochenschr

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“… 40 The current situation in Austria with a fee-for-service scheme, a high workload among GPs and an average consultation time of 5 min per patient might counteract trust building physician–patient relationships that are associated with vaccine acceptance. 22 , 41–43…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to a ‘Kassenarzt’, a ‘Wahlarzt’ is able to decide freely on opening hours, the amount of patients as well as the provided services and its costs. 21 , 22 …”

Section: Introductionmentioning

confidence: 99%

‘I’m not an anti-vaxer!’—vaccine hesitancy among physicians: a qualitative study

Ecker

Kutalek

2021

European Journal of Public Health

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Background Over the last years, research interest in vaccine hesitancy has increased. Studies usually focus on perceptions of parents and have largely neglected the group of health care providers. However, doctors’ notions on vaccination have a major impact on the decision-making process of their patients. We were interested to understand the phenomenon of vaccine hesitancy among physicians, with a particular focus on the measles vaccine. Furthermore, we aimed to understand the underlying perceptions of measles that may be associated with vaccine hesitant decisions. Methods In order to get an in-depth view, semi-structured interviews with physicians were conducted. Doctors were eligible for the study if they articulated vaccine hesitant views and/or demonstrated vaccine hesitancy in their medical practice. Results We interviewed 12 physicians, of whom 11 had a medical practice with no contract with the Austrian social insurance (‘Wahlarzt’) and additional training in complementary and alternative medicine. We found perceptions of immunology, health and illness that were discordant with evidence-based medicine and closely related to alternative and complementary medicine. All participants argued for a delayed administration of the measles vaccine. We found a consistent inclination towards ‘individual vaccination’, which was explained as empowering parents and to strengthen their decision-making competencies. Most participants expressed doubts about the reliability of vaccine studies and were concerned with possible long-term effects. Conclusions Paying closer attention to doctors’ concerns on vaccination might help to design target-oriented interventions to specifically strengthen vaccine confidence.

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“…A cross-sectional study in Taiwan shows that the trends of bypassing primary care for treatment of common diseases decreased from 2,000, but still high for diabetes in 2017 ( 41 ). Another study in Austria found that visiting specialists were quite common and the simple presence of a general practitioner as a usual source of care was insufficient ( 42 ). In Japan, patients also can access any medical institution without referral.…”

Section: Discussionmentioning

confidence: 99%

Patient Choice and Willingness Toward Gatekeepers as First-Contact Medical Institutions in Chinese Tiered Healthcare Delivery System: A Cross-Sectional Study

Zhang

Zhong

et al. 2021

Front. Public Health

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Introduction: Gatekeeping mechanism of primary care institutions (PCIs) is essential in promoting tiered healthcare delivery system in China. However, patients seeking for higher-level institutions instead of gatekeepers as their first contact has persisted in the past decade. This study aims to explain patients' choice and willingness and to provide potential solutions.Methods: A survey was conducted among residents who had received medical care within the previous 14 days. Patients' choice and willingness of PCIs for first contact together with influencing factors were analyzed using binary logistic regression.Results: Of 728 sampled patients in Hubei, 55.22% chose PCIs for first contact. Patients who are older, less educated, with lower family income, not living near non-PCIs, with better self-perceived health status, only buying medicines, and living in rural instead of urban area had significantly higher probability of choosing PCIs. As of willingness, over 90% of the patients inclined to have the same choice for their first contact under similar health conditions. Service capability was the primary reason limiting patients' choice of PCIs.Conclusions: The gatekeeper system did not achieve its goal which was 70% of PCIs among all kinds of institutions for first contact. Future measures should aim to improve gate-keepers' capability.

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The influence of general practitioners on access points to health care in a system without gatekeeping: a cross-sectional study in the context of the QUALICOPC project in Austria

Cited by 8 publications

References 26 publications

Patients’ perception of changes and consequences after tumor resection

Patients’ perception of changes and consequences after tumor resection

‘I’m not an anti-vaxer!’—vaccine hesitancy among physicians: a qualitative study

Patient Choice and Willingness Toward Gatekeepers as First-Contact Medical Institutions in Chinese Tiered Healthcare Delivery System: A Cross-Sectional Study

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