Résumé :
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[BDSP. Notice produite par INIST a0R0x9Np. Diffusion soumise à autorisation]. Context. Surveys carried out among users of medical services can be a useful tool for health care organizations in designing proper services. Specifically, patients'views of direct access to specialists can be useful to health organizations considering the gatekeeper model. Objective. To assess patients'opinions about direct access to specialists and referral to specialists through their primary care physician. Design. An intercept survey, in which patients were interviewed at the randomly selected service provision sites, was carried out in 3 districts in Israel during 1995. A total of 1445 and 1289 patients were interviewed in primary care and specialty clinics, respectively. Setting. - Primary care and specialty clinics in 3 regions in Israel serving 750000 members of Kupat Holim Clalit, Israel's largest sick fund. Participants. - Hebrew - speaking members of Kupat Holim Clalit who visited the primary care or specialty clinics in the 3 regions during the study period. Main Outcome Measures. - Rate of preferences for direct access to specialists and preferences for referral through primary care physician. Results. - Fifty-two percent of the respondents preferred direct access to specialists, while 48% preferred a referral from their primary care physician. Multivariate logistic regression analysis indicated that the preference for direct access was significantly lower among patients older than 45 years (odds ratio [OR], 0.75 ; 95% confidence interval [Cl], 0.62-0.91) (...)
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