Context. - There is concern in both the medical community and the general public about mechanisms of medical decision making and the interplay of physician and insurer decisions in determining access to care.
- To examine the medical process influencing access to growth hormone (GH) therapy for childhood short stature by comparing coverage policies of US insurers with the treatment recommendations of US physicians.
- lndependent national representative surveys were mailed to insurers (private, Blue Cross/Blue Shield, health maintenance organizations, programs for Children with Special Health Care Needs, and Medicaid programs, n=113), primary care physicians (n=1504), and pediatric endocrinologists (n=534) with response rates of 75%, 60%, and 81%, respectively.
Each survey included identical case scenarios.
Primary care physicians were asked decisions about referrals to pediatric endocrinologists.
Endocrinologists were asked GH treatment recommendations.
Insurers were asked coverage decisions for GH therapy.
- Insurer coverage decisions for GH in specific case scenarios were compared with the recommendations of primary care physicians and pediatric endocrinologists.
- Physician recommendations and insurance coverage decisions differed strikingly. (...)
Mots-clés Pascal : Assurance maladie, Médecin, Prise décision, Défaut croissance, Traitement, Chimiothérapie, Facteur croissance, Economie santé, Recommandation, Enfant, Homme, Endocrinopathie, Couverture sociale
Mots-clés Pascal anglais : Health insurance, Physician, Decision making, Growth defect, Treatment, Chemotherapy, Growth factor, Health economy, Recommendation, Child, Human, Endocrinopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0155323
Code Inist : 002B02O. Création : 21/07/1998.