Original Paper

Journal of Medical Systems

, Volume 32, Issue 1, pp 37-41

First online:

A Co-payment for Consultant Services: Primary Care Physicians’ Referral Actualization

  • Daniel A. VardyAffiliated withClalit Health Services, Southern districtDepartment of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev Email author 
  • , Tami FreudAffiliated withDepartment of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev
  • , Michael SherfAffiliated withClalit Health Services, Southern district
  • , Ofer SpilbergAffiliated withRabin Medical Center
  • , Dan GoldfarbAffiliated withClalit Health Services, Southern district
  • , Arnon D. CohenAffiliated withClalit Health Services, Southern districtDepartment of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev
  • , Shlomo Mor-YosefAffiliated withHadassah Medical Organization
  • , Pesach ShvartzmanAffiliated withClalit Health Services, Southern districtDepartment of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev

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Abstract

Prospective evaluation of the effect of a new co-payment for specialists consultations on actualization of referrals (2,432 patient), was examined. Actualization of the appointment, reasons for not actualizing, and sociodemographic characteristics were recorded. Actualization was 85.1% in community consultation clinics and 91.7% in hospital outpatient clinics. The main reasons for non actualization were: inability to reach the clinic (53.4%), the problem had resolved (15%), and co-payment (2%). In addition, 19.1% stated that they did not actualize a past consultant visit due to co-payment. Referring physicians noted that co-payment had some effect on their decision, especially with the elderly or lower income patients. A relatively small compulsory co-payment was not found to have a long term effect on utilization of specialists’ services.

Keywords

Co-payment Exemption Consultation Health services use