| Titre : | Contract medicine arrangements in Hong Kong : an example of risk-bearing provider networks in an unregulated environment. (2000) |
| Auteurs : | C. BRUDEVOLD ; L.M. HO ; S.M. MCGHEE ; University of Hong Kong. Department of Community Medicine. Pok Fu Lam. HKG |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 51, n° 8, 2000) |
| Pagination : | 1221-1229 |
| Langues: | Anglais |
| Mots-clés : | Hongkong ; Chine ; Asie ; Homme ; Etat santé ; Système santé ; Soins intégrés ; Motivation ; Qualité ; Soins |
| Résumé : | [BDSP. Notice produite par INIST MvuwsR0x. Diffusion soumise à autorisation]. It is increasingly common in Hong Kong and elsewhere for employers to contract directly with physician networks to provide medical services to employees. These contracts are known in Hong Kong as contract medicine arrangements. In other countries and areas, managed care organizations are generally required by regulation or legislation to ensure that services of adequate quality are provided to patients who are locked in to network providers. There are no such requirements in Hong Kong and concerns have been raised about potential quality and cost trade-offs in contract medicine arrangements. Satisfaction surveys were sent to contract medicine enrollees in one large company in Hong Kong. The response rate was 30% and analysis of non-respondent data shows that respondents were representative of their group. Comparison of satisfaction using logistic regression showed that risk-bearing networks paid by capitation had consistently lower satisfaction ratings across all major dimensions including access, interpersonal care, communication with the doctor, choice of doctor, and outcomes. These findings suggest that quality, at least as perceived by the patient, may be lower in these networks. The issue is of concern in Asia where infrastructures and data systems are not well developed to adequately monitor quality of care or protect patient interests. (...) |
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