Screening Primary-Care Patients Forgoing Health Care for Economic Reasons
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{"title"=>"Screening primary-care patients forgoing health care for economic reasons", "type"=>"journal", "authors"=>[{"first_name"=>"Patrick", "last_name"=>"Bodenmann", "scopus_author_id"=>"6602410044"}, {"first_name"=>"Bernard", "last_name"=>"Favrat", "scopus_author_id"=>"7003595063"}, {"first_name"=>"Hans", "last_name"=>"Wolff", "scopus_author_id"=>"7202884754"}, {"first_name"=>"Idris", "last_name"=>"Guessous", "scopus_author_id"=>"14826822100"}, {"first_name"=>"Francesco", "last_name"=>"Panese", "scopus_author_id"=>"6506121499"}, {"first_name"=>"Lilli", "last_name"=>"Herzig", "scopus_author_id"=>"22980001100"}, {"first_name"=>"Thomas", "last_name"=>"Bischoff", "scopus_author_id"=>"6603727438"}, {"first_name"=>"Alejandra", "last_name"=>"Casillas", "scopus_author_id"=>"7004073779"}, {"first_name"=>"Thomas", "last_name"=>"Golano", "scopus_author_id"=>"56132113600"}, {"first_name"=>"Paul", "last_name"=>"Vaucher", "scopus_author_id"=>"23398980600"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"24699726", "doi"=>"10.1371/journal.pone.0094006", "sgr"=>"84899435553", "isbn"=>"1932-6203", "scopus"=>"2-s2.0-84899435553", "issn"=>"19326203", "pui"=>"372953143"}, "id"=>"d3924d24-c94b-38d6-92f5-269627cc6d6a", "abstract"=>"Background Growing social inequities have made it important for general practitioners to verify if patients can afford treatment and procedures. Incorporating social conditions into clinical decision-making allows general practitioners to address mismatches between patients' health-care needs and financial resources. Objectives Identify a screening question to, indirectly, rule out patients' social risk of forgoing health care for economic reasons, and estimate prevalence of forgoing health care and the influence of physicians' attitudes toward deprivation. Design Multicenter cross-sectional survey. Participants Forty-seven general practitioners working in the French–speaking part of Switzerland enrolled a random sample of patients attending their private practices. Main Measures Patients who had forgone health care were defined as those reporting a household member (including themselves) having forgone treatment for economic reasons during the previous 12 months, through a self-administered questionnaire. Patients were also asked about education and income levels, self-perceived social position, and deprivation levels. Key Results Overall, 2,026 patients were included in the analysis; 10.7% (CI95% 9.4–12.1) reported a member of their household to have forgone health care during the 12 previous months. The question “Did you have difficulties paying your household bills during the last 12 months” performed better in identifying patients at risk of forgoing health care than a combination of four objective measures of socio-economic status (gender, age, education level, and income) (R 2 = 0.184 vs. 0.083). This question effectively ruled out that patients had forgone health care, with a negative predictive value of 96%. Furthermore, for physicians who felt powerless in the face of deprivation, we observed an increase in the odds of patients forgoing health care of 1.5 times. Conclusion General practitioners should systematically evaluate the socio-economic status of their patients. Asking patients whether they experience any difficulties in paying their bills is an effective means of identifying patients who might forgo health care.", "link"=>"http://www.mendeley.com/research/screening-primarycare-patients-forgoing-health-care-economic-reasons", "reader_count"=>24, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>7, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>1, "Student > Master"=>4, "Other"=>3, "Student > Bachelor"=>4, "Professor"=>2}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>7, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>1, "Student > Master"=>4, "Other"=>3, "Student > Bachelor"=>4, "Professor"=>2}, "reader_count_by_subject_area"=>{"Nursing and Health Professions"=>2, "Medicine and Dentistry"=>12, "Philosophy"=>1, "Arts and Humanities"=>1, "Psychology"=>1, "Social Sciences"=>6, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>12}, "Social Sciences"=>{"Social Sciences"=>6}, "Psychology"=>{"Psychology"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"Spain"=>1}, "group_count"=>3}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1448898"], "description"=>"<p>Determinants are (A) their household's ability to pay bills, (B) their daily available income, (C) their level of education, or (D) their household's sources of income. Intervals correspond to CI95%. CHF 1  =  US$ 1.10.</p>", "links"=>[], "tags"=>["Sociology", "Social research", "epidemiology", "Social epidemiology", "health care", "Health care policy", "Screening guidelines", "Primary care", "Socioeconomic aspects of health", "Public and occupational health", "Behavioral and social aspects of health", "research design", "Clinical research design", "Cross-sectional studies", "Observational studies", "Simulation and modeling", "patients", "affected", "forgoing", "healthcare"], "article_id"=>986280, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Patrick Bodenmann", "Bernard Favrat", "Hans Wolff", "Idris Guessous", "Francesco Panese", "Lilli Herzig", "Thomas Bischoff", "Alejandra Casillas", "Thomas Golano", "Paul Vaucher"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0094006.g002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_patients_affected_by_forgoing_healthcare_within_subpopulations_/986280", "title"=>"Prevalence of patients affected by forgoing healthcare within subpopulations.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-04-03 03:32:33"}
  • {"files"=>["https://ndownloader.figshare.com/files/1448899"], "description"=>"<p>*Not included in model 1 as this variable was highly correlated to a similar factor. <i>†</i> in Swiss Francs (CHF 1  =  US$ 1.10).</p>‡<p>More than one response was possible.</p>", "links"=>[], "tags"=>["Sociology", "Social research", "epidemiology", "Social epidemiology", "health care", "Health care policy", "Screening guidelines", "Primary care", "Socioeconomic aspects of health", "Public and occupational health", "Behavioral and social aspects of health", "research design", "Clinical research design", "Cross-sectional studies", "Observational studies", "Simulation and modeling", "studied", "univariate", "forgoing"], "article_id"=>986281, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Patrick Bodenmann", "Bernard Favrat", "Hans Wolff", "Idris Guessous", "Francesco Panese", "Lilli Herzig", "Thomas Bischoff", "Alejandra Casillas", "Thomas Golano", "Paul Vaucher"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0094006.t001", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Socio_economic_characteristics_of_studied_population_and_univariate_association_to_forgoing_health_care_/986281", "title"=>"Socio-economic characteristics of studied population and univariate association to forgoing health care.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-03 03:32:33"}
  • {"files"=>["https://ndownloader.figshare.com/files/1448900"], "description"=>"<p><i>*</i>In model 1, determinants were adjusted for age, gender, health status, and the clustering effect at a physician level.</p>†<p>In model 2, determinants were adjusted for age, gender, health status, physician does not endorse social role, physician seldom forgoes expensive treatment or investigations for deprived patients, and physician feels powerless when facing deprivation.</p>‡<p>Missing data was not associated to forgoing health care.</p><p>**CHF 1  =  US$ 1.1.</p>", "links"=>[], "tags"=>["Sociology", "Social research", "epidemiology", "Social epidemiology", "health care", "Health care policy", "Screening guidelines", "Primary care", "Socioeconomic aspects of health", "Public and occupational health", "Behavioral and social aspects of health", "research design", "Clinical research design", "Cross-sectional studies", "Observational studies", "Simulation and modeling", "forgoing"], "article_id"=>986282, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Patrick Bodenmann", "Bernard Favrat", "Hans Wolff", "Idris Guessous", "Francesco Panese", "Lilli Herzig", "Thomas Bischoff", "Alejandra Casillas", "Thomas Golano", "Paul Vaucher"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0094006.t003", "stats"=>{"downloads"=>1, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Odds_of_forgoing_health_care_n_8202_8202_2_026_/986282", "title"=>"Odds of forgoing health care (n = 2,026).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-03 03:32:33"}
  • {"files"=>["https://ndownloader.figshare.com/files/1448901"], "description"=>"<p>Subjective social determinants and association to forgoing health care.</p>", "links"=>[], "tags"=>["Sociology", "Social research", "epidemiology", "Social epidemiology", "health care", "Health care policy", "Screening guidelines", "Primary care", "Socioeconomic aspects of health", "Public and occupational health", "Behavioral and social aspects of health", "research design", "Clinical research design", "Cross-sectional studies", "Observational studies", "Simulation and modeling", "determinants", "forgoing"], "article_id"=>986283, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Patrick Bodenmann", "Bernard Favrat", "Hans Wolff", "Idris Guessous", "Francesco Panese", "Lilli Herzig", "Thomas Bischoff", "Alejandra Casillas", "Thomas Golano", "Paul Vaucher"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0094006.t002", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Subjective_social_determinants_and_association_to_forgoing_health_care_/986283", "title"=>"Subjective social determinants and association to forgoing health care.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-04-03 03:32:33"}
  • {"files"=>["https://ndownloader.figshare.com/files/1448897"], "description"=>"<p>Flow chart of the study population selection including patient recruitment, exclusion criteria, and refusals.</p>", "links"=>[], "tags"=>["Sociology", "Social research", "epidemiology", "Social epidemiology", "health care", "Health care policy", "Screening guidelines", "Primary care", "Socioeconomic aspects of health", "Public and occupational health", "Behavioral and social aspects of health", "research design", "Clinical research design", "Cross-sectional studies", "Observational studies", "Simulation and modeling", "exclusion"], "article_id"=>986279, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Patrick Bodenmann", "Bernard Favrat", "Hans Wolff", "Idris Guessous", "Francesco Panese", "Lilli Herzig", "Thomas Bischoff", "Alejandra Casillas", "Thomas Golano", "Paul Vaucher"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0094006.g001", "stats"=>{"downloads"=>12, "page_views"=>554, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_chart_of_the_study_population_selection_including_patient_recruitment_exclusion_criteria_and_refusals_/986279", "title"=>"Flow chart of the study population selection including patient recruitment, exclusion criteria, and refusals.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-04-03 03:32:33"}

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