title: Monetary and nonmonetary costs to patients attending an ambulatory dermatology clinic.
abstract: BACKGROUND
  Despite universal coverage under a provincial health plan, the residents of Ontario, Canada, still bear some costs for outpatient care, particularly for prescription drugs.
  
  
  OBJECTIVE
  To determine the financial and nonmonetary costs borne by patients presenting at a dermatology clinic in an academic centre, and to assess the extent to which these costs were problematic.
  
  
  METHODS
  Consecutive new patients in a 6-week period completed a self-administered questionnaire.
  
  
  RESULTS
  Eighty-six of 140 questionnaires (61%) were returned for analysis. The mean total cost to patients was C$28.92 (range $0 to $177.00). Medications were the largest expense (mean $35.66 for those receiving medication). Despite relatively prompt referrals (mean 12.4 days) and short in-office waiting time (mean 26.5 minutes), there was a trend for subjects to rate time costs as more problematic than monetary costs.
  
  
  CONCLUSIONS
  Patients attending a dermatology clinic bear variable monetary and nonmonetary costs. For some patients these costs may have the potential to impair access to care.
authors.affiliation: Department of Medicine, University of Toronto, Canada.
authors.forename: P M
authors.initials: PM
authors.lastname: Vignjevic
authors.forename: J E
authors.initials: JE
authors.lastname: Hux
authors.forename: B K
authors.initials: BK
authors.lastname: Fisher
authors.forename: J P
authors.initials: JP
authors.lastname: Szalai
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics*; D017281:Cost of Illness; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D009864:Ontario; D012017:Referral and Consultation; D012044:Regression Analysis; D012456:Salaries and Fringe Benefits / Q000191:economics; D012871:Skin Diseases / Q000191:economics*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014186:Transportation / Q000191:economics; D019472:Universal Health Insurance