ArticleBMC health services research2010
What doctors think about the impact of managed care tools on quality of care, costs, autonomy, and relations with patients.
Article in BMC health services research, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Doctors and patients' susceptibility to framing bias: a randomized trial.Journal of general internal medicine · 2011Trial
- The Primary Care Medical Record Industry in Canada and Its Data Collection and Commercialization Practices.JAMA network open · 2025Article
- German physicians' expectations of healthcare management companies: An exploratory study.Health science reports · 2022Article
- Physician perspectives on the implications of the diagnosis-related groups for medical practice in Turkey: A qualitative study.The International journal of health planning and management · 2022Article
- Physiotherapy for injured workers in Canada: are insurers' and clinics' policies threatening good quality and equity of care? Results of a qualitative study.BMC health services research · 2018Article
- Is medical perspective on clinical governance practices associated with clinical units' performance and mortality? A cross-sectional study through a record-linkage procedure.SAGE open medicine · 2016Article
- Future of family medicine: role of patient-centred care and evidence-based medicine.Canadian family physician Medecin de famille canadien · 2014Article
- "A manager in the minds of doctors:" a comparison of new modes of control in European hospitals.BMC health services research · 2013Article
- Implementation of pay for performance in primary care: a qualitative study 8 years after introduction.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Article
- Integrated care organizations in Switzerland.International journal of integrated care · 2011Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHow doctors perceive managed care tools and incentives is not well known. We assessed doctors' opinions about the expected impact of eight managed care tools on quality of care, control of health care costs, professional autonomy and relations with patients.
methodsMail survey of doctors (N = 1546) in Geneva, Switzerland. Respondents were asked to rate the impact of 8 managed care tools on 4 aspects of care on a 5-level scale (1 very negative, 2 rather negative, 3 neutral, 4 rather positive, 5 very positive). For each tool, we obtained a mean score from the 4 separate impacts.
resultsDoctors had predominantly negative opinions of the impact of managed care tools: use of guidelines (mean score 3.18), gate-keeping (2.76), managed care networks (2.77), second opinion requirement (2.65), pay for performance (1.90), pay by salary (2.24), selective contracting (1.56), and pre-approval of expensive treatments (1.77). Estimated impacts on cost control were positive or neutral for most tools, but impacts on professional autonomy were predominantly negative. Primary care doctors held more positive opinions than doctors in other specialties, and psychiatrists were in general the most critical. Older doctors had more negative opinions, as well as those in private practice.
conclusionsDoctors perceived most managed care tools to have a positive impact on the control of health care costs but a negative impact on medical practice. Tools that are controlled by the profession were better accepted than those that are imposed by payers.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.