[Low-income patients: Perception and determinants among medical students]

Abstract

Introduction: In France, more than 4 million people benefit from the universal complementary health insurance coverage (CMUc). Approved by many doctors, CMUc remains discussed by a part of the medical profession. What is the perception of general medical practice students regarding patients receiving CMUc and what are the determinants influencing it?

Methods: A cross-sectional study was carried out by providing final year interns in general medicine with a self-administered questionnaire. The primary assessment criterion was the perception of the interns regarding patients receiving CMUc, classified into three categories: positive, negative or neutral. After a description of the sample, statistical analysis included multivariate logistic polytomous regression models developed with the SAS 9.1 software.

Results: A total of 57.1% (200) of the third year interns of Île-de-France in 2009-2010 responded to the questionnaire. Forty-two percent of students had a "neutral" perception of the patients receiving CMUc, 41% a "positive" one and 17% a "negative" one. Influencing factors were: the perception of the first encounter, the gender of the intern, the type of practice that he intended to take up and the experience he had of patients receiving CMUc. In multivariate analysis, a positive impression of the first encounter significantly increased the probability of having a positive future perception compared to a negative impression of the first encounter (OR=16,19 [2,37-110,48]).

Discussion: To improve these perceptions, the main proposals are increased contacts with underprivileged populations and the close supervision of the students by their course tutors.