The influence of health insurance status on the organisation of patient care in Sydney public hospitals.
Utilising intensive semi-structured interviews with health professionals working in public hospitals in Sydney, a comparison was made of the perceived similarities and differences in the medical and administrative management of patients who were covered by Medicare and those who were privately insured. Interviewees argued that there was evidence of preferential access to public hospital care for privately insured patients due to medical misrepresentation of the urgency of their cases. They reported that some medical and administrative practices existed which compromised the choice of admission as a Medicare patient for those with private insurance, and for those without private insurance who were referred to hospital by a specialist. It was suggested also by the interviewees that medical considerations encouraged continuity of specialist care for Medicare patients admitted to hospital when they were known to an attending specialist. Such an allegation places in some doubt the claim made by private insurers that choice of doctor is permitted only under their cover. Interviewees did not report knowledge of any form of compromise in the quality of hospital care on the basis of medical preference for private patients. However, it was reported that private patients may, in some instances, be denied a full range of hospital services due to doctors' attempts to monopolise their treatment.
Department of Social Work and Social Policy, University of Sydney.
A
A
Davis
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C
Kerr
P
P
Lloyd
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R
Taylor
C
C
Waldby
D003266:Continuity of Patient Care / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics*; D006302:Health Services Research; D006779:Hospitals, Public / Q000191:economics* / Q000592:standards; D007348:Insurance, Health; D008483:Medical Assistance; D009313:National Health Programs; D009517:New South Wales; D010343:Patient Admission; D010361:Patients / Q000145:classification; D011332:Privatization; D011787:Quality of Health Care / Q000191:economics*; D012017:Referral and Consultation