Primary Care Office Policies Regarding Care of Uninsured Adult Patients
Article first published online: 9 JUN 2004
Journal of General Internal Medicine
Volume 16, Issue 10, pages 693–696, October 2001
How to Cite
O'Toole, T. P., Simms, P. M. and Dixon, B. W. (2001), Primary Care Office Policies Regarding Care of Uninsured Adult Patients. Journal of General Internal Medicine, 16: 693–696. doi: 10.1111/j.1525-1497.2001.00920.x
- Issue published online: 9 JUN 2004
- Article first published online: 9 JUN 2004
- uninsured patients;
- access to primary care;
- practice characteristics
OBJECTIVE: To describe primary care office policies regarding care of uninsured patients.
DESIGN: Telephone survey of all adult primary care sites advertising in the area telephone directory. Sites were defined by ownership status, number of physicians, use of physician-extenders, and location. Policies assessed were whether the site was accepting new uninsured patients, billing policies, the availability of free or discounted care, and payment plans.
SETTING: Allegheny County, Pennsylvania.
PARTICIPANTS: Of the 359 sites identified, 240 (66.9%) responded, representing 794 physicians. Survey respondents included receptionists (40.4%), office managers (36.2%), and physicians (22.9%).
RESULTS: While the majority of all sites reported accepting new patients without health insurance (87.5%), policies regarding these patients varied significantly by ownership status and the number of physicians. Sites with 3 or fewer physicians were more likely to accept uninsured patients. Self-owned practices were more likely to require payment at the time of service, and provide discounted care, free care, and payment plans compared with hospital/health system practices or multisite group practices.
CONCLUSIONS: Willingness to accept uninsured patients does not always equate to affordable or accessible care. Office policies have the potential to be substantial obstacles to primary care.