This report discusses gatekeeping and how it operates in New Zealand’s health system. It discusses the relationship between primary and specialist care in the United States, which does not use gatekeeping. Lastly, it compares the health system consequences of a gatekeeping system vs non gatekeeping system, in relation to access, quality and efficiency of health system.
Gatekeeping in health care is where primary care providers (PCPs) regulate patients’ access into further care. Patients access secondary and tertiary care only through referrals from primary care (Cumming, et al., 2014). Primary care is the base level of health system, involving General Practitioners (GPs) treating common sickness (Bodenheimer and Grumbach, 2009). An aspect of …show more content…
Bodenheimar and Grumbach (2009) suggests that sometimes specialists can provide higher quality care compared to generalists when treating conditions in their specific expertise area, as they would have had training and clinical experience.
However, gatekeeping system in NZ can also increase human input side of clinical quality by ensuring patients get access to the right specialists, as GPs with clinical expertise are better equipped than patients themselves to match the right services for a particular patient’s needs (Bodenheimer and Grumbach, 2009). In comparison, US patients have personal autonomy to choose specialists they consider best for their medical needs. However, patients may refer themselves to specialists when there is no real need, or to inappropriate specialists, which will then reduce quality received. (Bodenheimer and Grumbach, …show more content…
Each country’s health system can be improved. In NZ, gatekeeping can be improved through better coordination of health services and fairness in deciding elective treatments (Cumming, et al., 2014). As gatekeepers, GPs must ensure consistency and equity in referral system, so gatekeeping is used to match appropriate health services for patients, not just as means to limit costs. In specialist-dominated US health system, with no formal gatekeeping, there is higher health expenditure and lower health outcomes (Rice, Rosenau, Unruh, Barnes,
Gatekeeping in health care is where primary care providers (PCPs) regulate patients’ access into further care. Patients access secondary and tertiary care only through referrals from primary care (Cumming, et al., 2014). Primary care is the base level of health system, involving General Practitioners (GPs) treating common sickness (Bodenheimer and Grumbach, 2009). An aspect of …show more content…
Bodenheimar and Grumbach (2009) suggests that sometimes specialists can provide higher quality care compared to generalists when treating conditions in their specific expertise area, as they would have had training and clinical experience.
However, gatekeeping system in NZ can also increase human input side of clinical quality by ensuring patients get access to the right specialists, as GPs with clinical expertise are better equipped than patients themselves to match the right services for a particular patient’s needs (Bodenheimer and Grumbach, 2009). In comparison, US patients have personal autonomy to choose specialists they consider best for their medical needs. However, patients may refer themselves to specialists when there is no real need, or to inappropriate specialists, which will then reduce quality received. (Bodenheimer and Grumbach, …show more content…
Each country’s health system can be improved. In NZ, gatekeeping can be improved through better coordination of health services and fairness in deciding elective treatments (Cumming, et al., 2014). As gatekeepers, GPs must ensure consistency and equity in referral system, so gatekeeping is used to match appropriate health services for patients, not just as means to limit costs. In specialist-dominated US health system, with no formal gatekeeping, there is higher health expenditure and lower health outcomes (Rice, Rosenau, Unruh, Barnes,