The influence of increased health care costs on general practitioner consultations and prescription collection

Abstract

Aim: Increased health service charges have led to concern that some patients may be unable to meet these costs, which could compromise their care. Increased costs may affect general practitioner attendance, and/or the collection of a prescription. This study examines both of these factors.

Methods: Between 18 August and 14 September 1992, questionnaires were sent to the consenting patients of 19 general practitioners from the Hutt Valley requesting information regarding the general practice (GP) visit and the prescription. The information included the reason for the GP visit, whether there was any delay and its duration, the reason for any delay, the cost of the visit and whether a prescription was received. Data regarding the prescription included the cost and whether all, some, or none of the items were uplifted, and whether the patient had a community service card.

Results: 489 (86%) returned completed questionnaires and 426 received a prescription. Of these, 164 were group 1 community service card holders; one was a group 2 community service card holder; 186 were group 3; 59 did not specify their group; 18 had a chronic-user card. Forty percent (194 patients), delayed going to their doctor, 118 by more than 3 days. The most common reasons for delay were hope that their condition may improve spontaneously and the cost of the consultation or prescription. Possession of a community service card was a significant factor in delay with group 3 (high wage earners) more likely to delay than group 1 (p < 0.0005). Only two patients did not present their prescription. Ninety-three percent of those receiving a prescription presented for dispensing within 24 hours. Ninety-two percent of patients paid for all their prescription items.

Conclusions: Delay in obtaining treatment is common and occurs primarily at the general practitioner consultation. It primarily affects those individuals who were classified as group 3, the group that has taken the burden of recent health service charges increases.