Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan
Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan
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DOI：
10.1136/jech.52.6.370
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发表时间：
1998-06-01
影响因子：
6.3
通讯作者：
Perneger, TV
中科院分区：
文献类型：
--
作者：
Etter, JF;Perneger, TV
Study objectives-To assess whether the introduction of "managed care" (capitated budget and utilisation control by general practitioners) in a Swiss health insurance plan caused a selective disenrolment of plan members, and whether it achieved its goal of reducing health care expenditures.Design-Controlled before-after analysis of health insurance claims.Setting-Health insurance plan of the University of Geneva, Switzerland, which introduced managed care at the end of 1992, and comparison plan, which reimbursed health care expenditures without setting a budget or controlling access.Participants-Analysis of self selection: university plait members who accepted (3993) or refused (659) transfer to managed care. Analysis of change in expenditures: cohorts of persons continuously enrolled in the university (1575) and comparison (3384) plans in 1992 and 1993.Main results-During 1992, the year before the transformation of the university plan, persons who refused managed care had generated 35% higher expenditures than those who accepted managed care (p
