Low-Income Patients Prefer Hospital to Outpatient Care

Urban patients cite lower cost, ease of access, and better care as reasons for using hospital care

THURSDAY, July 11 (HealthDay News) -- Patients in low socioeconomic groups who live in urban settings report that they prefer hospital care to ambulatory care because it is less expensive, more accessible, and superior in quality, according to research published in the July issue of Health Affairs.

Shreya Kangovi, M.D., of the Philadelphia Veterans Affairs Medical Center, and colleagues conducted qualitative interviews with 40 patients of low socioeconomic status (SES) in an urban hospital setting to explore why they use more acute hospital care and less primary care than patients with high SES.

The researchers found that urban patients of low SES prefer hospital care because they perceive it to be less costly, easier to access, and better in quality than ambulatory care. Two patterns were identified for patient profiles. Profile A represented patients reporting social dysfunction and disability who had five or more acute care episodes in six months. Profile B represented patients reporting social stability who had fewer than five acute care episodes in six months. Profile B patients described accessing ambulatory care as difficult.

"Although preferential use of hospital care by these patients is low value, it is not irrational," the authors write. "The patients in our study articulated clear, logical reasons for preferring hospital to ambulatory care."

One study author disclosed financial ties to pharmaceutical companies.

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Physician’s Briefing Staff

Physician’s Briefing Staff

Published on July 11, 2013

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