TY - JOUR
T1 - The physician as gatekeeper
T2 - Determinants of physicians’ hospitalization rates
AU - Rosenblatt, Roger A.
AU - Moscovice, Ira S.
PY - 1984/2
Y1 - 1984/2
N2 - The authors studied differences in the rate of hospitalization of a random sample of all general and family practitioners in the state of Washington. The study was designed to identify nonmedical factors that affect the rate at which physicians hospitalize ambulatory patients. They found that the hospitalization rate varied greatly among physicians and that this rate appeared to be sensitive to nonmedical factors. The following independent variables were significantly associated with higher rates of hospitalization while controlling for other factors: Low hospital occupancy rates, low per capita income in the county, group practice, a broader scope of outpatient practice, and a busier outpatient practice. They conclude that physicians are sensitive to a range of nonmedical factors in their decision to utilize hospital resources. These findings suggest that a substantial proportion of all hospitalizations are discretionary, and that changes in practice organization or hospital occupancy rates will affect the rate of hospital use.
AB - The authors studied differences in the rate of hospitalization of a random sample of all general and family practitioners in the state of Washington. The study was designed to identify nonmedical factors that affect the rate at which physicians hospitalize ambulatory patients. They found that the hospitalization rate varied greatly among physicians and that this rate appeared to be sensitive to nonmedical factors. The following independent variables were significantly associated with higher rates of hospitalization while controlling for other factors: Low hospital occupancy rates, low per capita income in the county, group practice, a broader scope of outpatient practice, and a busier outpatient practice. They conclude that physicians are sensitive to a range of nonmedical factors in their decision to utilize hospital resources. These findings suggest that a substantial proportion of all hospitalizations are discretionary, and that changes in practice organization or hospital occupancy rates will affect the rate of hospital use.
KW - Family practitioners
KW - Group practice
KW - Hospital occupancy rates
KW - Hospitalization
KW - Hospitalization rates
KW - Outpatient medical practice
KW - Physician decision making
UR - http://www.scopus.com/inward/record.url?scp=0021366061&partnerID=8YFLogxK
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U2 - 10.1097/00005650-198402000-00006
DO - 10.1097/00005650-198402000-00006
M3 - Article
C2 - 6700275
AN - SCOPUS:0021366061
SN - 0025-7079
VL - 22
SP - 150
EP - 159
JO - Medical care
JF - Medical care
IS - 2
ER -