Disparities/Minority Health

Study identifies attributes of surgeons more willing to provide charity care

No organized system exists for the delivery of elective surgical care to uninsured U.S. residents. Local access to care programs (LACPs) represent a promising strategy for providing uninsured patients with access to timely non-emergency care. These programs, typically administered by a local nonprofit agency, provide a structured set of health benefits to eligible uninsured patients at little or no cost. A new study identifies surgeons who are more likely to provide charity care for LACPs.

Researchers from the University of North Carolina at Chapel Hill and Duke University used survey data to determine which demographic and practice characteristics were associated with a surgeon's willingness to provide charity care. They found that a greater amount of charity care was provided by surgeons who were male, owned their own practice, were employed in academic medical centers, or earned a greater proportion of their revenue from Medicaid. The strongest predictors of charity care hours were academic practice and share of income derived from Medicaid. Surgeons who worked in a group HMO were significantly less likely to provide any charity care.

Participation in LACPs has some advantages over ad hoc pro bono care. For example, LACPs obtain commitments from local hospitals to provide enrolled patients with needed laboratory tests and other services. Also, LACPs provide their patients with many services such as transportation and translation assistance. This study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).

See "Characterizing and fostering charity care in the surgeon workforce," by D. Brad Wright, Ph.D., and John E. Scarborough, M.D., in the July 2011 Annals of Surgery 254(1), pp. 169-173.

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