U.S. teaching hospitals, many of which are located in inner-city areas, are often considered key providers of health services to uninsured and underinsured patients. However, a recent survey of teaching hospital faculty finds that such physicians may have difficulty accessing specialty care for their uninsured patients. The study from the Institute for Health Policy at Massachusetts General Hospital (MGH) appears in the November/December issue of Health Affairs.

"Our research suggests that the so-called safety net has more holes than previously thought," says Joel S. Weissman, PhD, the report's lead author. "Even patients who get initial access to care in our nation's teaching hospitals may have significant problems getting referred for specialty care and high-tech services or getting admitted for a non-emergency condition. What is notable is that these problems obtaining services occurred in both private and public institutions."

The research team surveyed more than 2,000 physicians at U.S. academic health centers who had provided direct patient care during the preceding year. Among the questions asked were whether the physicians were unable to admit uninsured patients or had to limit such patients' hospital care; how often they could obtain specialty referrals or advanced services such as organ transplants or cardiac stents for either insured or uninsured patients, and whether their physician group practices had policies limiting their ability to care for uninsured patients.

Among study respondents, about 25 percent reported problems with admitting an uninsured patient or having to limit that patient's care. Respondents were nine times as likely to report difficulty obtaining specialty care for their uninsured patients as they were for privately insured patients, with particular problems accessing non-emergency hospital admissions, h
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
12-Nov-2003