Cargando…
Provider accountability as a driving force towards physician–hospital integration: a systematic review
BACKGROUND: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased....
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Igitur publishing
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447218/ https://www.ncbi.nlm.nih.gov/pubmed/26034469 |
_version_ | 1782373560345427968 |
---|---|
author | Trybou, Jeroen Gemmel, Paul Annemans, Lieven |
author_facet | Trybou, Jeroen Gemmel, Paul Annemans, Lieven |
author_sort | Trybou, Jeroen |
collection | PubMed |
description | BACKGROUND: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated. PURPOSE: To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models. RESULTS: Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration. CONCLUSION: The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately. |
format | Online Article Text |
id | pubmed-4447218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Igitur publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-44472182015-06-01 Provider accountability as a driving force towards physician–hospital integration: a systematic review Trybou, Jeroen Gemmel, Paul Annemans, Lieven Int J Integr Care Research and Theory BACKGROUND: Hospitals and physicians lie at the heart of our health care delivery system. In general, physicians provide medical care and hospitals the resources to deliver health care. In the past two decades many countries have adopted reforms in which provider financial risk bearing is increased. By making providers financially accountable for the delivered care integrated care delivery is stimulated. PURPOSE: To assess the evidence base supporting the relationship between provider financial risk bearing and physician–hospital integration and to identify the different types of methods used to measure physician–hospital integration to evaluate the functional value of these integrative models. RESULTS: Nine studies met the inclusion criteria. The evidence base is mixed and inconclusive. Our methodological analysis of previous research shows that previous studies have largely focused on the formal structures of physician–hospital arrangements as an indicator of physician–hospital integration. CONCLUSION: The link between provider financial risk bearing and physician–hospital integration can at this time be supported merely on the basis of theoretical insights of agency theory rather than empirical research. Physician–hospital integration measurement has concentrated on the prevalence of contracting vehicles that enables joint bargaining in a managed care environment but without realizing integration and cooperation between hospital and physicians. Therefore, we argue that these studies fail to shed light on the impact of risk shifting on the hospital–physician relationship accurately. Igitur publishing 2015-03-31 /pmc/articles/PMC4447218/ /pubmed/26034469 Text en Copyright 2015, Authors retain the copyright of their article http://creativecommons.org/licenses/by/3.0/ This work is licensed under a (http://creativecommons.org/licenses/by/3.0) Creative Commons Attribution 3.0 Unported License |
spellingShingle | Research and Theory Trybou, Jeroen Gemmel, Paul Annemans, Lieven Provider accountability as a driving force towards physician–hospital integration: a systematic review |
title | Provider accountability as a driving force towards physician–hospital integration: a systematic review |
title_full | Provider accountability as a driving force towards physician–hospital integration: a systematic review |
title_fullStr | Provider accountability as a driving force towards physician–hospital integration: a systematic review |
title_full_unstemmed | Provider accountability as a driving force towards physician–hospital integration: a systematic review |
title_short | Provider accountability as a driving force towards physician–hospital integration: a systematic review |
title_sort | provider accountability as a driving force towards physician–hospital integration: a systematic review |
topic | Research and Theory |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447218/ https://www.ncbi.nlm.nih.gov/pubmed/26034469 |
work_keys_str_mv | AT tryboujeroen provideraccountabilityasadrivingforcetowardsphysicianhospitalintegrationasystematicreview AT gemmelpaul provideraccountabilityasadrivingforcetowardsphysicianhospitalintegrationasystematicreview AT annemanslieven provideraccountabilityasadrivingforcetowardsphysicianhospitalintegrationasystematicreview |