Potential impact of co-payment at point of care to influence emergency department utilization

PeerJ

article

Zachary Baum¹  Michael R. Simmons¹  Jose H. Guardiola²  Cynthia Smith¹  Lynn Carrasco³  Joann Ha¹  Peter Richman¹ 

[1] Department of Emergency Medicine, Christus Spohn/Texas A & M Health Science Center;Department of Mathematics, Texas A & M University—Corpus Christi;Graduate Medical Education, Christus Spohn/Texas A & M Health Science Center

关键词: Emergency department;    Co-payment;    Utilization;   

DOI  :  10.7717/peerj.1544

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

Background. Many proponents for healthcare reform suggest increased cost-sharing by patients as a method to reduce overall expenditures. Prior studies on the effects of co-payments for ED visits have generally not been directed toward understanding patient attitudes/behavior at point of care.Objectives. We conducted a survey at point of care to test our hypothesis that a significant number of patients with urgent chief complaints might have avoided the ED if asked to provide a co-payment.Methods.500 would have impacted their decision to visit the ED. Categorical data are presented as frequency of occurrence and analyzed by chi-square; continuous data presented as means ± standard deviation, analyzed by t-tests. ORs and 95% confidence intervals provided. Primary outcome parameter was the % of patients who would have avoided the ED if asked to pay any co-payment for several urgent chief complaints: chest pain, SOB, and abdominal pain.Results.20,000 were more willing to pay a co-payment (OR = 2.55; 95% CI [1.59–4.10]). No significant relationship was identified between willingness to pay for: gender, race, education, established primary care provider, and frequency of ED visits.Conclusion. Overall, 30.2% of our patients would not have accepted a co-pay in order to be seen, including more than 20% of the patients with chest pain, shortness of breath, and abdominal pain respectively.

【 授权许可】

CC BY