Effect of high up front charges on access to surgery for poor patients at a public hospital in New Mexico
| Autor: | Arthur Kaufman, Betty J. Skipper, Augustine S Chavez, William H. Kaufman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
business.industry Public health lcsh:Public aspects of medicine Health Policy Research Health services research Ethnic group Public Health Environmental and Occupational Health lcsh:RA1-1270 Confidence interval Nursing Relative risk Public hospital medicine business Elective Surgical Procedure human activities Health policy health care economics and organizations Demography |
| Zdroj: | International Journal for Equity in Health International Journal for Equity in Health, Vol 5, Iss 1, p 6 (2006) |
| ISSN: | 1475-9276 |
| Popis: | Background A public hospital in New Mexico required collection of 50% of estimated costs prior to elective surgeries for self-pay patients. This study assesses the impact of this policy on access to elective surgical procedures. Methods Chi-square tests determined if there was a statistically significant difference between the number of self-pay and insured patient cancellations for financial reasons. A multivariate binomial regression model was used to calculate risk ratios and confidence limits for effects of race/ethnicity, and insurance status, controlling for gender, on these cancellations. Results Of the 667 cancellations, there were 99 self-pay and 568 insured patients. Cancellations for financial reasons occurred in 55.6% of self-pay and 9.3% of insured patients (p < 0.0001). Inability to pay 50% up front accounted for 76.4% of self-pay patient cancellations for financial reasons. Self-pay, non-Hispanic whites and minority race/ethnicities were 8.76 and 8.61 times more likely to cancel for financial reasons, respectively, than insured non-Hispanic whites. Conclusion Self-pay patients, regardless of race/ethnicity, have elective surgical procedures cancelled for financial reasons significantly more often than insured patients. The hospital's 50% up-front payment policy represents a significant financial barrier to accessing elective surgical procedures for self-pay patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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