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July 1989

Out-of-Pocket Payments and Use of Care for Serious and Minor Symptoms: Results of a National Survey

Author Affiliations

From the Departments of Medicine (Drs Shapiro and Hayward) and Sociology (Dr Freeman and Mr Corey), University of California, Los Angeles, and the Survey Research Laboratory, University of Illinois at Champaign-Urbana (Dr Sudman); and the Division of General Internal Medicine, University of Michigan Medical Center, Ann Arbor (Dr Hayward).

Arch Intern Med. 1989;149(7):1645-1648. doi:10.1001/archinte.1989.00390070153025

• To assess the effect of out-of-pocket payments on use of care for symptoms that physicians consider serious and meriting care, and for minor symptoms, we evaluated data from a 1986 national survey. Among 5412 adults reporting one or more medical visits in the last year, 18.8% had experienced serious symptoms within the previous 30 days, among whom 63.0% sought care, while 31.3% had experienced minor symptoms, among whom 42.8% sought care. Subjects who had paid $15 or less out of pocket for their last medical visit were more likely to seek care for a serious symptom (67.1% vs 52.6%) or for a minor symptom (47.1% vs 32.2%) than were those who paid $30 or more. Large out-of-pocket payments are associated with significant reductions in use of care for both serious and minor symptoms.

(Arch Intern Med. 1989;149:1645-1648)