Patients' Insurance Status Affects Clinical Decision-Making

Physicians frequently alter clinical management to take insurance into account

WEDNESDAY, Sept. 27 (HealthDay News) -- Physicians frequently take into account a patient's insurance status during the course of clinical decision-making and management, according to a study published in the September/October issue of the Annals of Family Medicine.

David S. Meyers, M.D., of the Agency for Healthcare Research and Quality in Rockville, Md., and colleagues conducted a survey of 25 primary care physicians in metropolitan Washington, D.C., who completed a brief questionnaire after seeing each patient during two half-day sessions.

In all, 88 percent of participants made at least one change to clinical management because of the insurance status of the patient. Out of 409 patient encounters, they made changes in 99 cases (24.2 percent). The most affected were uninsured patients: changes were made in 43.5 percent of uninsured patients' cases, versus 29.5 percent for publicly insured patients and 18.7 percent for privately insured patients. Insurance issues were discussed with patients in 62.6 percent of visits.

"Additional research is needed to understand the effect of these changes on patient health and to assist both doctors and patients in enhancing the quality of care delivered within the constraints of the current insurance system," the authors conclude.

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