An Advantage of using the gatekeeper system is that, since primary care doctors typically charge less, the cost of health care is reduced. Under ideal conditions, the primary care provider functions, focus on the health of the whole person rather than on a single organ system in the body. The primary care provider emphasizes the importance of prevention and establishes a schedule for age-appropriate health screening. When a suspected problem does exist, the provider can make the initial diagnosis, advise the patient on further treatment and make necessary referrals. The fact that all medical records are kept in one location also contributes to care that is better coordinated. A 2014 study compared non-gatekeeping Austria and the gatekeeping USA, showing that Austrian patients seek help in the secondary and tertiary sector four times more frequently than in the USA. The study revealed that a country lacking formal regulation in terms of primary to secondary and tertiary care referrals such as Austria, led to a high over-utilization of secondary and tertiary care facilities.

Some disadvantages may arise; whereas, few services may be provided, in order to control costs. This may limit access to specialists or costlier tests and procedures. In regards to financing, many primary care doctors are compensated for their services via capitation rates and or fee-for-services. This creates some competition on the market to retain patients and if a primary care doctor were to hand over patients to a specialist too quickly, they could lose part of their funding. On the other hand, if a primary care doctor is too careful or reserved with forwarding patients to specialists, the patient may feel denied access to secondary healthcare.  The average age of a patient that a primary care doctor attends to on a daily basis is increasing. Elderly aged patients are more likely to present a plurality of medical ailments and more frequently require medical care for comorbidities. In a traditional gatekeeping mechanism this elderly individual would be sent to several specialists, which is tiring, time-consuming and potentially delivers him or her a fragmented care approach

References:

http://missourifamilies.org/features/healtharticles/health44.htm

Gatekeeping in Healthcare – an evaluation

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