Research at the Interface of Primary and Specialty Care. Conference SummaryReport. Held in September 1995

摘要

In the U.S. Health care system, the roles and responsibilities of primary careand specialist providers have traditionally overlapped, often resulting in confusion among providers and patients, as well as redundant or inadequate care. Newer health care plans and reimbursement mechanisms are requiring clinicians to assume more clearly defined roles as either primary care or specialist providers, and they are attempting to limit patient access to specialists, who have been found to use significantly more resources than primary care providers. These organizational changes appear to be aimed at reducing costs while improving the effectiveness of care. There is, however, a conspicuous absence of scientifc data on the costs, outcomes, and quality of the care being delivered as a result of changes occuring at the interface of primary and specialty care. More information is urgently needed to help define appropriate provider roles and facilitate more science-based decisions about the appropriate use of primary and specialty services. This report summarizes presentations at a conference. 'Research at the Interface of Primary and Specialty Care,' convened in September 1995 by the Agency of Health Care Policy and Research. A list of potential research topics and a bibliography to help readers locate more information are provided.