Managed care and physicians'provision of charity care.
Context Health system changes may be affecting the ability of physicians to provide care with little or no compensation from patients who are uninsured and under-insured and may result in decreased access to physicians for uninsured persons.
Objective To examine the association between managed care and physicians'provision of charity care.
Design The 1996-1997 Community Tracking Study physician survey.
Setting and Participants A nationally representative sample of 10881 physicians from 60 randomly selected communities.
Main Outcome Measure The number of hours in the month prior to the interview that the physician provided care for free or at reduced fees because of the financial need of the patient.
Results Overall, 77.3% of respondents provided an average of 10.3 hours of charity care per week.
Physicians who derive at least 85% of their practice revenue from managed care plans were considerably less likely to provide charity care and spend fewer hours providing charity care than physicians with little involvement in managed care plans (P=01).
In addition, physicians who practice in areas with high managed care penetration provided fewer hours of charity care than physicians in other areas, regardless of their own level of involvement with managed care (P<. 01). (...)
Mots-clés Pascal : Soin intégré, Relation médecin malade, Questionnaire, Paiement, Assurance maladie, Critère sélection, Pauvreté, Programme sanitaire, Homme, Etats Unis, Amérique du Nord, Amérique, Politique sanitaire, Soins gratuits
Mots-clés Pascal anglais : Managed care, Physician patient relation, Questionnaire, Payment, Health insurance, Selection criterion, Poverty, Sanitary program, Human, United States, North America, America, Health policy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0235341
Code Inist : 002B30A03A. Création : 16/11/1999.