Physicians consider their patients' insurance status when making clinical decisions and frequently alter their clinical management as a result, according to a recent study described in the September-October issue of the Annals of Family Medicine. The study's purpose was to better understand why Americans without health insurance receive fewer services and have poorer health status than those who have insurance.
In September 2002, 25 physician members of a primary-care, practice-based research network in Washingtoncalled Capricorncompleted a brief survey immediately after each of their patient encounters during two half-day sessions. They reported altering their management during 99 of 409 patient encounters, or a little more than 24%.
"When we thought about this, what we were able to say clearly is that doctors use insurance information in deciding what to offer for patients,'' said David Meyers, the study's lead author and adjunct assistant clinical professor of family medicine at Georgetown University Medical Center. Since the study was completed, Meyers has become a medical officer in the center for primary care, prevention and clinical partnerships at the Agency for Healthcare Research and Quality.