Who cares for uninsured persons? A study of physicians and their patients who lack health insurance

Abstract

Physician involvement with uninsured patients is a topic of increasing policy interest. In the past, data limitations have hindered analysis of factors influencing physician contact with uninsured patients. This article attempts to bridge this gap in the health services research literature. Using a nationally representative sample of nonfederal patient care physicians, the study revealed marked variations in physician involvement with uninsured patients by specialty class, employment status, and other practice characteristics. Pediatricians and general practitioners had roughly comparable involvement with uninsured patients, while internists and surgeons were significantly less involved. Self-employed physicians generally participated less in caring for uninsured patients than did employed physicians. While definitive evidence that people without coverage face serious access problems is not provided, such a conclusion is certainly consistent with the results of this study. Indeed, the proportion of the average physician's patients who are uninsured is substantially below current estimates of the proportion of the general population that is uninsured.