eISSN: 2449-8580
ISSN: 1734-3402
Family Medicine & Primary Care Review
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1/2020
vol. 22
 
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abstract:
Original paper

The Gatekeeper Model: patient’s view on the role of the family physician

Tengiz Verulava
1, 2
,
Beka Dangadze
3
,
Revaz Jorbenadze
4
,
Ana Lordkipanidze
2
,
Leila Karimi
5
,
Ekaterine Eliava
6

1.
Public Health and Insurance Institute, School of Business, Ilia State University, Tbilisi, Georgia
2.
Faculty of Social and Political Sciences, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
3.
Health Policy Institute, Tbilisi, Georgia
4.
G. Chapidze Emergency Cardiology Centre, Tbilisi, Georgia
5.
La Trobe University, School of Psychology and Public Health
6.
Senamedi Hospital
Family Medicine & Primary Care Review 2020; 22(1): 75–79
Online publish date: 2020/03/20
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Background
An adequate primary healthcare system substantially determines the quality of health of the population and effective spending of healthcare resources. The family physician, serving as a ‘gatekeeper’, can make judicious decisions about the appropriate use of medical services.

Objectives
The goal of this study was to find out patients’ characteristics, preferences and behaviour in regard to the role of the family physician as a gatekeeper in the Republic of Georgia.

Materials and methods
As part of a cross-sectional quantitative study, respondents were interviewed using a structured questionnaire.

Results
A majority of the respondents (53.7%, n = 245) had a permanent family physician, but were not satisfied with the level of the family physician’s professionalism (56.6%, n = 258) and preferred self-referral to specialists (55%, n = 253). Only 19.5% (n = 89) referred to specialists upon the family physician’s advice, who would coordinate all services, and 23% (n = 103) have used both family physicians and self-referral. Private health insurance companies were more interested in implementing cost reducing mechanisms rather than the Social Service Agency (which is responsible for the Universal Health Care Programme).

Conclusions
It is appropriate to share private health insurance experiences for developing the model of a gatekeeper in the UHCP. In order to improve a family physician institute and increase confidence in it, it is recommended to raise the level of family physicians’ skills in their relations with patients, as this has a significant effect on patient preferences. It is advisable to develop a flexible and voluntary gatekeeper model which will better suit the needs of both patients and physicians.

keywords:

primary healthcare, family physician, referral to family physician, Georgia (Republic)

 
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