ArticleBMC health services research2018
Factors influencing government insurance scheme beneficiary acceptance of the gatekeeper policy: a cross-sectional study in Wuhan, China.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Understanding the Impact of COVID-19 on the Utilization of Community Health Services: Evidence from Beijing in China.Healthcare (Basel, Switzerland) · 2025Article
- The effect of incentive factors on turnover intention of PHC workforce in rural China-from the perspective of two-factor theory.BMC health services research · 2024Article
- Factors Affecting the Preference for Hospitals Over Clinics in Primary Care in Korea.Journal of Korean medical science · 2024Article
- Patients' Willingness of First Visit in Primary Medical Institutions and Policy Implications: A National Cross-Sectional Survey in China.Frontiers in public health · 2022Article
- Current status on the ability of the elderly in rural China: implications for future nursing and policy.Cardiovascular diagnosis and therapy · 2020Article
- Satisfaction with service coverage and drug list may influence patients' acceptance of general practitioner contract service: a cross-sectional study in Guangdong, China.BMC health services research · 2019Article
- Key nodes affecting patient satisfaction in a cross-regional referral service process: an empirical analysis study in Sichuan.BMC health services research · 2018Article
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10 authors.
Funding
Abstract
backgroundGatekeeper policy, requiring a patient to visit a primary care provider first, and the patient needs to get his or her primary care provider's referral before seeing a specialist or going to a hospital, has been implemented in China for about ten years, and it is necessary to assess the patients' acceptance of gatekeeper policy and to explore the factors influencing patients' acceptance.
methodsA cross-sectional study with 1162 respondents was conducted between July and September 2015 at four community health centers (CHCs) in Wuhan, China. Face-to-face interview was used to collect information on demographics, acceptance of the gate keeper policy and satisfaction with community health services. Patients' satisfaction with community health service was evaluated using the European Patients Evaluate General/Family Practice scale and binary logistic regression model was used to examine the factors influencing patients' acceptance of community health services as gate keepers.
resultsA total of 512 (43.06%) patients accepted gatekeeper policy. Mandatory reimbursement provision (OR: 1.63, 95% CI: 1.23-2.15), patient satisfaction with the aspects of medical care (OR: 1.92, 95% CI: 1.12-3.29) and organization of care (OR: 1.66, 95% CI: 1.05-2.62) were associated with acceptance of gatekeeper policy, after adjusting for potential confounders. Moreover, young people (OR: 0.35, 95%CI: 0.22-0.56) seemed to be more reluctant to accept the policy, when compared with the elder.
conclusionsOur study suggests that mandatory reimbursement provision greatly affects patients' acceptance of gatekeeper policy, therefore, the policy-maker should pay attention to the negative effect of its mandatory reimbursement provision on patients' acceptance of the policy. However, improving the aspects of medical care and organization of care will contribute to implementation of gatekeeper policy.
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