Screening primary-care patients forgoing health care for economic reasons.

<h4>Background</h4>Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating social conditions into clinical decision-making allows general practitioners to address mismatches between patients'...

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Autores principales:	Patrick Bodenmann, Bernard Favrat, Hans Wolff, Idris Guessous, Francesco Panese, Lilli Herzig, Thomas Bischoff, Alejandra Casillas, Thomas Golano, Paul Vaucher
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/44145e8d271946a5ba175dc09dcd5f29
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spelling	oai:doaj.org-article:44145e8d271946a5ba175dc09dcd5f292021-11-18T08:24:59ZScreening primary-care patients forgoing health care for economic reasons.1932-620310.1371/journal.pone.0094006https://doaj.org/article/44145e8d271946a5ba175dc09dcd5f292014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24699726/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating social conditions into clinical decision-making allows general practitioners to address mismatches between patients' health-care needs and financial resources.<h4>Objectives</h4>Identify a screening question to, indirectly, rule out patients' social risk of forgoing health care for economic reasons, and estimate prevalence of forgoing health care and the influence of physicians' attitudes toward deprivation.<h4>Design</h4>Multicenter cross-sectional survey.<h4>Participants</h4>Forty-seven general practitioners working in the French-speaking part of Switzerland enrolled a random sample of patients attending their private practices.<h4>Main measures</h4>Patients who had forgone health care were defined as those reporting a household member (including themselves) having forgone treatment for economic reasons during the previous 12 months, through a self-administered questionnaire. Patients were also asked about education and income levels, self-perceived social position, and deprivation levels.<h4>Key results</h4>Overall, 2,026 patients were included in the analysis; 10.7% (CI95% 9.4-12.1) reported a member of their household to have forgone health care during the 12 previous months. The question "Did you have difficulties paying your household bills during the last 12 months" performed better in identifying patients at risk of forgoing health care than a combination of four objective measures of socio-economic status (gender, age, education level, and income) (R(2) = 0.184 vs. 0.083). This question effectively ruled out that patients had forgone health care, with a negative predictive value of 96%. Furthermore, for physicians who felt powerless in the face of deprivation, we observed an increase in the odds of patients forgoing health care of 1.5 times.<h4>Conclusion</h4>General practitioners should systematically evaluate the socio-economic status of their patients. Asking patients whether they experience any difficulties in paying their bills is an effective means of identifying patients who might forgo health care.Patrick BodenmannBernard FavratHans WolffIdris GuessousFrancesco PaneseLilli HerzigThomas BischoffAlejandra CasillasThomas GolanoPaul VaucherPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e94006 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Patrick Bodenmann Bernard Favrat Hans Wolff Idris Guessous Francesco Panese Lilli Herzig Thomas Bischoff Alejandra Casillas Thomas Golano Paul Vaucher Screening primary-care patients forgoing health care for economic reasons.
description	<h4>Background</h4>Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating social conditions into clinical decision-making allows general practitioners to address mismatches between patients' health-care needs and financial resources.<h4>Objectives</h4>Identify a screening question to, indirectly, rule out patients' social risk of forgoing health care for economic reasons, and estimate prevalence of forgoing health care and the influence of physicians' attitudes toward deprivation.<h4>Design</h4>Multicenter cross-sectional survey.<h4>Participants</h4>Forty-seven general practitioners working in the French-speaking part of Switzerland enrolled a random sample of patients attending their private practices.<h4>Main measures</h4>Patients who had forgone health care were defined as those reporting a household member (including themselves) having forgone treatment for economic reasons during the previous 12 months, through a self-administered questionnaire. Patients were also asked about education and income levels, self-perceived social position, and deprivation levels.<h4>Key results</h4>Overall, 2,026 patients were included in the analysis; 10.7% (CI95% 9.4-12.1) reported a member of their household to have forgone health care during the 12 previous months. The question "Did you have difficulties paying your household bills during the last 12 months" performed better in identifying patients at risk of forgoing health care than a combination of four objective measures of socio-economic status (gender, age, education level, and income) (R(2) = 0.184 vs. 0.083). This question effectively ruled out that patients had forgone health care, with a negative predictive value of 96%. Furthermore, for physicians who felt powerless in the face of deprivation, we observed an increase in the odds of patients forgoing health care of 1.5 times.<h4>Conclusion</h4>General practitioners should systematically evaluate the socio-economic status of their patients. Asking patients whether they experience any difficulties in paying their bills is an effective means of identifying patients who might forgo health care.
format	article
author	Patrick Bodenmann Bernard Favrat Hans Wolff Idris Guessous Francesco Panese Lilli Herzig Thomas Bischoff Alejandra Casillas Thomas Golano Paul Vaucher
author_facet	Patrick Bodenmann Bernard Favrat Hans Wolff Idris Guessous Francesco Panese Lilli Herzig Thomas Bischoff Alejandra Casillas Thomas Golano Paul Vaucher
author_sort	Patrick Bodenmann
title	Screening primary-care patients forgoing health care for economic reasons.
title_short	Screening primary-care patients forgoing health care for economic reasons.
title_full	Screening primary-care patients forgoing health care for economic reasons.
title_fullStr	Screening primary-care patients forgoing health care for economic reasons.
title_full_unstemmed	Screening primary-care patients forgoing health care for economic reasons.
title_sort	screening primary-care patients forgoing health care for economic reasons.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/44145e8d271946a5ba175dc09dcd5f29
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Screening primary-care patients forgoing health care for economic reasons.

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