SCIENCE / MEDICINE : Costs Seen to Deter Patients

Health care co-payments--an increasingly popular tool for controlling the rising costs of medical insurance--appear to deter patients from seeking treatment not only for minor complaints but also for serious symptoms, a new UCLA study suggests.

The study found that the higher the out-of-pocket payment required, the less likely patients were to consult a physician. That principle applied even with serious symptoms, such as chest pain, that physicians agree should receive medical attention.

In the survey of 5,412 adults, 63% of those reporting serious symptoms in the previous month had seen a physician. Of those patients required to pay $30 or more out of pocket, 52.6% saw a doctor, compared to 67.1% of those paying $15 or less.

The study’s authors, led by Dr. Martin F. Shapiro, said the findings raised questions about the wisdom of co-payments: “It would be considerably less attractive as a policy option if people did not receive care that they needed, or if their health suffered from assignment to a co-insurance plan.”