Managed care and physician referral.
In the era of managed care, fundamental changes are occurring in the American health care system that are altering physician referral patterns.
Faced with higher premiums that erode profits and competitiveness, employers, government, and nonprofit agencies are contracting with managed care organizations, which control costs partly by imposing constraints and incentives on physician referral behavior.
As more and more Americans are covered by managed care plans, it becomes more important to understand how managed care organizations control access to specialists and how these controls affect health outcomes.
The authors present a model defining the expected influence of managed care on physician referral based on social exchange theory and the empirical literature.
They conclude with a discussion of the future research implications of the model.
Mots-clés Pascal : Soin intégré, Système santé, Organisation santé, Transfert, Orientation, Malade, Homme, Médecin généraliste, Spécialité médicale, Etats Unis, Amérique du Nord, Amérique, Contrôle coût, Economie santé, Article synthèse, Modèle
Mots-clés Pascal anglais : Managed care, Health system, Public health organization, Transfer, Orientation, Patient, Human, General practitioner, Medical specialty, United States, North America, America, Cost control, Health economy, Review, Models
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0168786
Code Inist : 002B30A01B. Création : 21/07/1998.