Increased patient cost-sharing may hurt elderly

January 27, 2010 By ALICIA CHANG , AP Science Writer

(AP) -- Higher Medicare copays, sometimes just a few dollars more, led to fewer doctors visits and to more and longer hospital stays, a large new study reveals.

With health care costs skyrocketing, many public and have required patients to pay more out-of-pocket when they seek care. The new study confirms what many policymakers had feared: cost-shifting moves can backfire.

"Patients may defer needed care and may wind up with a serious health event that might put them in the hospital. That's not good for the patients, not good for society, not good for anybody," said Dr. Tim Carey, who heads the University of North Carolina's Sheps Center for Health Services Research.

Carey had no role in the research, published in Thursday's .

The study included nearly 900,000 seniors in 36 Medicare managed-care plans from 2001 to 2006. During that period, half of the plans raised copays for visits to doctors and specialists. Researchers compared medical use patterns in those plans with use in similar Medicare managed-care plans that kept copays the same. Copays for prescription drugs remained unchanged in all plans.

Among plans that increased patient cost-sharing, the average copay for a doctor visit roughly doubled, from $7.38 to $14.38. The copay to see a specialist jumped from $12.66 to $22.05. By contrast, the average copay for unchanged plans was $8.33 to see a doctor and $11.38 to see a specialist.

For every 100 people enrolled in plans that raised copays, there were 20 fewer doctor visits, 2 additional hospital admissions and 13 more days spent in the hospital in the year after the increase compared to those in plans whose copays did not change, researchers found.

The trend was most pronounced among blacks, people living in lower-income neighborhoods and those with chronic illnesses such as diabetes, or heart disease.

The results suggest that raising copays to contain costs is counterproductive, said Dr. Amal Trivedi, assistant professor of community health at Brown University, who led the study. Not only may it lead to higher health care spending, but patients also suffer, he said.

"Outpatient care for elderly adults, particularly those with chronic diseases, is very valuable and may not be something you want to discourage by having a large copayment," Trivedi said.

The study was funded by grants from Pfizer Inc. and the federal government.

The findings echo previous studies on increased patient cost-sharing. When California's Medicaid program introduced a $1 copay in 1972, it led to an 8 percent decline in doctor visits and a 17 percent increase in days.

More information: New England Journal: http://www.nejm.org

shares

Related Stories

Recommended for you

Vigorous physical activity may be linked to heightened risk of motor neurone disease

April 23, 2018
Vigorous physical activity, either in leisure time or in work, may be linked to a heightened risk of developing motor neurone disease, also known as amyotrophic lateral sclerosis, or ALS for short, suggests research published ...

Fetal exposure to moderate/high caffeine levels linked to excess childhood weight gain

April 23, 2018
Exposure to moderate to high caffeine levels while in the womb is linked to excess weight gain in early childhood, suggests a large observational study published in the online journal BMJ Open.

Alcohol intake may be linked to premenstrual syndrome

April 23, 2018
Drinking alcohol may be linked to pre-menstrual syndrome, or PMS for short, suggests a pooled analysis of published study data in the online journal BMJ Open.

Suicide and homicide rates show large racial disparities across US states

April 23, 2018
Southern and Western states have the highest rates of white firearm suicide, while Midwestern states have highest rates of black firearm homicide, according to new research from McGill University. The findings place a spotlight ...

Upswings in older-age cognitive ability may not be universal

April 23, 2018
A growing body of evidence indicates that rates of dementia may be declining, in part because older adults' cognitive abilities, such as learning and memory functions, are better than those of older adults in the past. But ...

Male contraceptive compound stops sperm without affecting hormones

April 20, 2018
A new study published today in the journal PLOS ONE details how a compound called EP055 binds to sperm proteins to significantly slow the overall mobility of the sperm without affecting hormones, making EP055 a potential ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.