PATIENT CHARGES - A HINDRANCE TO FINANCIALLY AND PSYCHOSOCIALLY DISADVANTAGE GROUPS SEEKING CARE

This study examines the extent to which people forego seeking primary health care due to the cost and to investigate the associated demograp hic, physical, psychological and social factors. In 1995, questionnair es were sent to a random sample of the population in two healthcare re gions in the Stockholm area in Sweden covering a total of about 400 00 0 inhabitants. Among the sample of 8200 people over the age of 17 yr, 69% replied to the questionnaire. About 22% stated that on one or more occasions during the past year they had foregone seeking care due to the cost. About 30% stated that they had foregone or hesitated seeking medical help due to the cost during the past year. This applied to wo men to a greater extent than men. Not seeking medical care was strongl y correlated to a self-assessment of personal finances. Among those wh o described their financial situation as poor, more than half stated t hat, on at least one occasion, they had foregone seeking medical care due to the cost, As a consequence, weaker groups in society such as th e unemployed, students. foreign nationals and single mothers were over represented in this group. Those who had foregone care perceive their health as worse and they had a greater degree of general pains and a h igher occurrence of chronic disease/disability compared to those who h ad not foregone care. Between 1970 and 1995, patient charges for consu lting a general practitioner within Stockholm County have increased mo re than three times faster than the consumer price index. The results suggest that the rapidly increasing patient charges particularly affec t the weaker social groups and thus pose a threat to the aim of Swedis h healthcare legislation - that good care should be available to every one on equal terms. (C) 1998 Elsevier Science Ltd. All rights reserved .