Health care utilization and attitudes toward health insurance. A comparison of privately insured and medical assistance or uninsured patients.

A questionnaire was distributed to 108 patients to find if there were differences in health care resource usage and attitudes towards health insurance between patients seen in the hand clinic, designed for patients with medical assistance or without insurance (57 patients), and those seen in the private offices of staff hand surgeons (51 patients). Clinic patients reported a mean of 18 visits to their physician in the past year as compared with 7 for private patients (P < 0.0005) and attended 52% of their scheduled appointments as compared to an 83% attendance rate for private patients (P < 0.001). Patients enrolled in a medical assistance program were less willing to pay for their health care than were private patients. Sixty-two percent of clinic patients responded that they would not be willing to pay anything at all for their health care coverage. These data suggest that health care and health insurance is a lower priority for the clinic patient. Any new health care system that includes the uninsured and underinsured must be prepared to handle different attitudes toward health care and an increase in utilization of resources.