» Articles » PMID: 8604765

Switching Swiss Enrollees from Indemnity Health Insurance to Managed Care: the Effect on Health Status and Stisfaction with Care

Overview
Specialty Public Health
Date 1996 Mar 1
PMID 8604765
Citations 9
Authors
Affiliations
Soon will be listed here.
Abstract

Objectives: In 1992, most members of a Swiss indemnity health insurance plan were automatically transferred into a newly created managed care organization. This study examined whether this semivoluntary change affected enrollees' health status and satisfaction with care.

Methods: Three groups of enrollees were compared: 332 plan members who accepted the switch (managed care joiners); 186 plan members who opted to maintain indemnity coverage (non-joiners); and 296 persons continuosly enrolled in another indemnity plan (indemnity plan members). Health status, health related behaviors, and satisfaction with care received in the previous year were surveyed at baseline and 1 year later.

Results: Health status remained unchanged in all three groups. Smoking prevalence decreased among managed care joiners but remained constant in the other groups. Satisfaction with insurance coverage increased between baseline and follow-up in managed care joiners, but decreased in nonjoiners and indemnity plan members. The latter groups had higher satisfaction with health care, particularly with continuity of care.

Conclusions: A semivoluntary switch from indemnity health insurance to managed care reduced satisfaction with health care but increased satisfaction with insurance coverage. There were no changes in self-perceived health status.

Citing Articles

Factors influencing government insurance scheme beneficiary acceptance of the gatekeeper policy: a cross-sectional study in Wuhan, China.

Li W, Wang D, Gan Y, Zhou Y, Chen Y, Li J BMC Health Serv Res. 2018; 18(1):241.

PMID: 29615013 PMC: 5883636. DOI: 10.1186/s12913-018-3010-4.


Gatekeeping and the utilization of community health services in Shenzhen, China: A cross-sectional study.

Li W, Gan Y, Dong X, Zhou Y, Cao S, Kkandawire N Medicine (Baltimore). 2017; 96(38):e7719.

PMID: 28930820 PMC: 5617687. DOI: 10.1097/MD.0000000000007719.


Patient Satisfaction with Community Health Service Centers as Gatekeepers and the Influencing Factors: A Cross-Sectional Study in Shenzhen, China.

Wu J, Zhang S, Chen H, Lin Y, Dong X, Yin X PLoS One. 2016; 11(8):e0161683.

PMID: 27552228 PMC: 4994937. DOI: 10.1371/journal.pone.0161683.


Integrated care organizations in Switzerland.

Berchtold P, Peytremann-Bridevaux I Int J Integr Care. 2011; 11 Spec Ed:e010.

PMID: 21677845 PMC: 3111889.


The effects of gatekeeping: a systematic review of the literature.

Velasco Garrido M, Zentner A, Busse R Scand J Prim Health Care. 2011; 29(1):28-38.

PMID: 21192758 PMC: 3347935. DOI: 10.3109/02813432.2010.537015.


References
1.
Davies A, Ware Jr J, Brook R, Peterson J, NEWHOUSE J . Consumer acceptance of prepaid and fee-for-service medical care: results from a randomized controlled trial. Health Serv Res. 1986; 21(3):429-52. PMC: 1068962. View

2.
Ware Jr J, Brook R, Rogers W, Keeler E, Davies A, Sherbourne C . Comparison of health outcomes at a health maintenance organisation with those of fee-for-service care. Lancet. 1986; 1(8488):1017-22. DOI: 10.1016/s0140-6736(86)91282-1. View

3.
Luft H . HMOs and the quality of care. Inquiry. 1988; 25(1):147-56. View

4.
Cleary P, McNeil B . Patient satisfaction as an indicator of quality care. Inquiry. 1988; 25(1):25-36. View

5.
MURRAY J . A follow-up comparison of patient satisfaction among prepaid and fee-for-service patients. J Fam Pract. 1988; 26(5):576-81. View