title: Effects of cost sharing on care seeking and health status: results from the Medical Outcomes Study.
abstract: OBJECTIVE
  This study sought to determine the effect of cost sharing on medical care use for acute symptoms and on health status among chronically ill adults.
  
  
  METHODS
  Data from the Medical Outcomes Study were used to compare (1) rates of physician care use for minor and serious symptoms and (2) 6- and 12-month follow-up physical and mental health status among individuals at different levels of cost sharing.
  
  
  RESULTS
  In comparison with a no-copay group, the low- and high-copay groups were less likely to have sought care for minor symptoms, but only the high-copay group had a lower rate of seeking care for serious symptoms. Follow-up physical and mental health status scores were similar among the 3 copay groups.
  
  
  CONCLUSIONS
  In a chronically ill population, cost sharing reduced the use of care for both minor and serious symptoms. Although no differences in self-reported health status were observed, health plans featuring cost sharing need careful monitoring for potential adverse health effects because of their propensity to reduce use of care that is considered necessary and appropriate.
authors.affiliation: Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, USA. miwong@mednet.ucla.edu
authors.forename: M D
authors.initials: MD
authors.lastname: Wong
authors.forename: R
authors.initials: R
authors.lastname: Andersen
authors.forename: C D
authors.initials: CD
authors.lastname: Sherbourne
authors.forename: R D
authors.initials: RD
authors.lastname: Hays
authors.forename: M F
authors.initials: MF
authors.lastname: Shapiro
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D017047:Cost Sharing / Q000145:classification*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000191:economics* / Q000706:statistics & numerical data; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology