Forgoing health care under universal health insurance: the case of France.

Details

Serval ID
serval:BIB_3302BE2A4B18
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Forgoing health care under universal health insurance: the case of France.
Journal
International journal of public health
Author(s)
Feral-Pierssens A.L., Rives-Lange C., Matta J., Rodwin V.G., Goldberg M., Juvin P., Zins M., Carette C., Czernichow S.
ISSN
1661-8564 (Electronic)
ISSN-L
1661-8556
Publication state
Published
Issued date
06/2020
Peer-reviewed
Oui
Volume
65
Number
5
Pages
617-625
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
We investigate the reliability of a survey question on forgone healthcare services for financial reasons, based on analysis of actual healthcare use over the 3-year period preceding response to the question. We compare the actual use of different health services by patients who report having forgone health care to those who do not.
Based on a prospective cohort study (CONSTANCES), we link survey data from enrolled participants to the Universal Health Insurance (UHI) claims database and compare use of health services of those who report having forgone health care to controls. We present multivariable logistic regression models and assess the odds of using different health services.
Compared to controls, forgoing care participants had lower odds of consulting GPs (OR = 0.83; 95% CI 0.73, 0.93), especially specialists outside hospitals (gynecologists: 0.74 (0.69, 0.78); dermatologists: 0.81 (0.78-0.85); pneumologists 0.82 (0.71-0.94); dentists 0.71 (0.68, 0.75)); higher odds of ED visits (OR = 1.25; 95% CI 1.19, 1.31); and no difference in hospital admissions (OR = 1.02; 95% CI 0.97, 1.09). Participants with lower occupational status and income had higher odds of forgoing health care.
The perception of those who report having forgone health care for financial reasons is consistent with their lower actual use of community-based ambulatory care (CBAC). While UHI may be necessary to improve healthcare access, it does not address the social factors associated with the population forgoing health care for financial reasons.
Keywords
Adolescent, Adult, Aged, Bayes Theorem, Female, France, Health Services Accessibility/organization & administration, Health Services Accessibility/statistics & numerical data, Humans, Logistic Models, Male, Middle Aged, Office Visits/statistics & numerical data, Office Visits/trends, Patient Acceptance of Health Care/statistics & numerical data, Prospective Studies, Reproducibility of Results, Surveys and Questionnaires, Universal Health Insurance/organization & administration, Universal Health Insurance/statistics & numerical data, Young Adult, Access to care, Social deprivation, Universal Health Insurance (UHI), Unmet healthcare needs
Pubmed
Web of science
Create date
10/06/2020 21:37
Last modification date
06/04/2024 7:23
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