How to coordinate the care for patients with chronic diseases when general practitioners have no gatekeeping function?

Justification and interest of the workshop Coordination of care is a core function of primary care and its goal is to support patients, especially those with chronic diseases and their families to receive effective health care within an increasingly complex healthcare system. Coordinated care is characterized by five basic features: gatekeeping system, primary care practice and team structure, skill-mix of primary care providers, integration of primary and secondary care, and integration of primary care and public health. Although the gatekeeping function of general practitioners seems to be the most basic feature, coordinated care could be achieved in the absence of a gatekeeping system. In the health care systems of several European countries, including Turkey, general practitioners have no gatekeeping function. In this workshop we aim to discuss how to improve coordination of care within healthcare systems without gatekeeping function of general practitioners. Learning goals: We aim to find an answer to the following question: how can the coordination of care for patients with chronic diseases be improved in healthcare systems without a gatekeeping function of general practitioners? The goal is to identify potentially useful measures to improve the coordination of care by comparing the accessibility and service profiles of general practitioners, and the care needs and health care utilisation patterns of patients in health care systems with and without a gatekeeping function. Methods: The discussions in the subgroups will be preceded by three short presentations resulting in the abovementioned question to be discussed in the subgroups. Subgroup discussions are expected to focus on experiences of participants and what options they see to improve coordination of care in their countries. Each subgroup will subsequently report these points in the final plenary part of the workshop. Expected impact on the participants At the end of workshop, the participants will have gained a comprehension of the coordinated care in healthcare systems in different European countries with and without a gatekeeping function of general practitioners and of implications for their own countries