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Uninsured patients face obstacles to treatment at a tertiary hand center
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Investigators found that patients with Medicaid insurance or without health insurance that need elective hand surgery had a harder time accessing local and tertiary care than patients with Medicare and private insurance.
“Economically disadvantaged patients face barriers to accessing specialty surgical care,” Ryan P. Calfee, MD, MSc, and colleagues stated in the study abstract. “Among patients with Medicaid coverage or no insurance, local surgical care is less likely to be offered and yet personal resources may limit a patient’s ability to reach distant centers for non-emergency care.”
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Calfee and colleagues reported in results of their retrospective cohort study that no-show rates at their tertiary hand surgery center significantly positively correlated with the distance patients had to travel to the center. Furthermore, patients with Medicaid insurance were significantly more likely than patients with private insurance to not show up for appointments, according to the abstract.
Based on a survey of primary care physicians that the researchers conducted, 62% of local hand specialists accepted Medicaid insurance and 100% of local surgeons accepted patients with private insurance. Forty-four percent of those surveyed reported that those patients refused treatment by community surgeons because they did not have Medicaid or another form of insurance also had limited resources to drive to the tertiary center, according to the abstract.
Disclosure: The research was supported by a National Center for Research Resources grant.
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