Physicians report trouble obtaining specialty services for uninsured

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Health-care safety net found to have significant limitations at both public and private hospitals

A research team surveyed more than 2,000 physicians at U.S. academic health centers who had provided direct patient care during the preceding year. Among the questions asked were whether the physicians were unable to admit uninsured patients or had to limit such patients’ hospital care; how often they could obtain specialty referrals or advanced services – such as organ transplants or cardiac stents – for either insured or uninsured patients, and whether their physician group practices had policies limiting their ability to care for uninsured patients. Among study respondents, about 25 percent reported problems with admitting an uninsured patient or having to limit that patient’s care. Respondents were nine times as likely to report difficulty obtaining specialty care for their uninsured patients as they were for privately insured patients, with particular problems accessing non-emergency hospital admissions, high-tech services, and outpatient mental health and substance abuse services. “Our research suggests that the so-called safety net has more holes than previously thought,” says Joel S. Weissman, the report’s lead author. The study from Massachusetts General Hospital appeared in the November/December 2003 issue of Health Affairs. The research was supported by The Commonweath Fund, The Pew Charitable Trusts, Burroughs Wellcome and the Doris Duke Charitable Foundation.