There's a hole in the bucket: an analysis of the impact of the medical card review process on patient entitlement to free health care.
In 2001 the frequency of reviewing medical-card eligibility was increased. This study assessed the impact of this policy change on patient entitlement to free health care. Data on reasons for patient removal from a GP's General Medical Services (GMS) list during a two and a half year period was analysed. During this period, 1489 (89% CI 87-91%) patients from the practice list were removed for non-return of review forms. Forty patients randomly selected from patients deleted from the list in 2006 were interviewed. Sixty percent said they had not received a review form and 91% (CI 82-100%) believed they were entitled to a medical card. In the period without medical card cover, cost prevented 11% (CI 1-21%) of those who felt they were eligible from accessing medical care while 26% (CI 12-40%) paid 'out-of-pocket'. This study shows that a bureaucratic policy change has negatively affected access to health care.
O'Carroll
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A
Mountjoy Street Practice, 53 Mountjoy Street, Dublin. aocarroll@rcsi.ie
O'Reilly
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F
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D004608:Eligibility Determination / Q000706:statistics & numerical data*; D005260:Female; D005568:Forms and Records Control; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008483:Medical Assistance / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data; D012189:Retrospective Studies