Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Cost to patients barrier to counseling for obesity and smoking

02.02.2010
Researchers urge health care policy makers and payers to consider coverage

Reducing obesity and smoking have become national priorities in the United States. Research has shown that intensive counseling can positively impact each problem. However, because such counseling is typically not covered by medical insurance, cost can be a barrier.

In a study published in the March 2010 issue of the American Journal of Preventive Medicine, researchers from Virginia Commonwealth University, Richmond, Virginia, found that when primary care clinicians and community counselors collaborated to offer free counseling services to patients, there was an overwhelming positive response. Yet, when the same services were offered at a cost to the patient, there was a significant drop in participation.

An electronic linkage system (eLinkS) was used to prompt healthcare providers to suggest intensive healthcare counseling for adult patients with unhealthy behaviors. eLinkS then helped to facilitate and automate referrals and communication between primary care practices and community programs. During a 5-week period when funding was available, 5679 patients were evaluated, 1860 had at least one unhealthy behavior (triggering an eLinkS prompt), and 407 (21.8%) were referred for intensive counseling.

In a 3-week period after funding was exhausted, 2510 patients visited the practices, 729 triggered an eLinkS prompt, but only 5 (0.7%) were referred for intensive counseling. Compared to the coverage period, the overall referral rate for patients with an unhealthy behavior decreased by 97%. Practice nurses asked 22% fewer patients about health behaviors (37% vs 29%). When prompted by eLinkS, clinicians offered referrals to 79% fewer patients (29% vs 6%). If a referral was offered, 81% fewer patients accepted (76% vs 14%).

Patients confirmed that costs introduced a barrier to counseling. Some patients were explicit that charges would prevent participation while others who had deferred counseling in the past were motivated to enroll because it was free. Clinicians reported that removing cost as an impediment, combined with an easy means to refer patients, allowed patient discussions to focus on behavior change. The heightened patient interest reversed when charges were reinstituted. Fewer successes also diminished motivation for the counselors.

Alex H. Krist MD, MPH, Virginia Commonwealth University, Department of Family Medicine, and his co-investigators comment, "Our quantitative and qualitative data underscore that clinicians, not just patients, are influenced by costs. Despite prompts, nurses were less likely to record patients' BMI and smoking status during the no-coverage period, triggering fewer eLinkS prompts. Clinicians were also less likely to discuss health behaviors with patients. However, even when clinicians did offer a referral, 81% fewer patients accepted. …This study indicates that policymakers and payers should support clinical–community partnerships and eliminate cost as a barrier to intensive smoking cessation and weight loss counseling. Modifying health behaviors is daunting enough for patients and clinicians – cost can be the tipping point in their decision to forego the effort."

The article is "Patient Costs As a Barrier to Intensive Health Behavior Counseling" by Alex H Krist, MD, MPH, Steven H Woolf, MD, MPH, Robert E Johnson, PhD, Stephen F Rothemich, MD, MS, Tina D Cunningham, Resa M Jones, MPH, PhD, Diane B Wilson, EdD, RD, and Kelly J Devers, PhD. The article appears in the American Journal of Preventive Medicine, Volume 38, Issue 3 (March 2010) published by Elsevier.

AJPM Editorial Office | EurekAlert!
Further information:
http://www.ucsd.edu

Further reports about: Commonwealth MPH Medicine PhD Preventive Medicine preventive primary care

More articles from Health and Medicine:

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

nachricht Better equipped in the fight against lung cancer
16.05.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

Im Focus: Dozens of binaries from Milky Way's globular clusters could be detectable by LISA

Next-generation gravitational wave detector in space will complement LIGO on Earth

The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...

Im Focus: Entangled atoms shine in unison

A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.

The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

 
Latest News

Designer cells: artificial enzyme can activate a gene switch

22.05.2018 | Life Sciences

PR of MCC: Carbon removal from atmosphere unavoidable for 1.5 degree target

22.05.2018 | Earth Sciences

Achema 2018: New camera system monitors distillation and helps save energy

22.05.2018 | Trade Fair News

VideoLinks
Science & Research
Overview of more VideoLinks >>>