Primary care office policies regarding care of uninsured adult patients.
OBJECTIVE
To describe primary care office policies regarding care of uninsured patients.


METHODS
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.


METHODS
Allegheny County, Pennsylvania.


METHODS
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.
O'Toole
T P
TP
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Md. 21205, USA. totoole@jhmi.edu
Simms
P M
PM
Dixon
B W
BW
D000328:Adult; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D017057:Medically Uninsured; D016134:Organizational Policy; D010414:Pennsylvania; D011216:Practice Management, Medical / Q000458:organization & administration*; D017664:Uncompensated Care