       Document 0744
 DOCN  M9640744
 TI    Health insurance and use of medical services by men infected with HIV.
 DT    9604
 AU    Katz MH; Chang SW; Buchbinder SP; Hessol NA; O'Malley P; Doll LS; AIDS
       Office, Department of Public Health, San Francisco, CA; 94102-6033, USA.
 SO    J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;8(1):58-63.
       Unique Identifier : AIDSLINE MED/96142201
 AB    Among 178 HIV-infected men from the San Francisco City Clinic Cohort
       (SFCCC), we examined the association between health insurance and use of
       outpatient services and treatment. For men with private insurance, we
       also assessed the frequency of avoiding the use of health insurance. Men
       without private insurance reported fewer outpatient visits than men with
       fee-for-service or managed-care plans. Use of zidovudine for eligible
       men was similar for those with fee-for-service plans (74%), managed-care
       plans (77%), or no insurance (61%). Use of Pneumocytstis carinii
       pneumonia prophylaxis was similar for those with fee-for-service (93%)
       and managed-care plans (83%) but lower for those with no insurance
       (63%). Of 149 men with private insurance, 31 (21%) reported that they
       had avoided using their health insurance for medical expenses in the
       previous year. In multivariate analysis, the independent predictors of
       avoiding the use of insurance were working for a small company and
       living outside the San Francisco Bay Area. Having private insurance
       resulted in higher use of outpatient services, but the type of private
       insurance did not appear to affect the use of service or treatment.
       Fears of loss of coverage and confidentiality may negate some benefits
       of health insurance for HIV-infected persons.
 DE    Adult  Ambulatory Care/ECONOMICS/STATISTICS & NUMER DATA/*UTILIZATION
       Antiviral Agents/THERAPEUTIC USE  Cohort Studies  Emergency Service,
       Hospital/ECONOMICS/STATISTICS & NUMER DATA/  *UTILIZATION  Human  HIV
       Infections/*COMPLICATIONS/DRUG THERAPY/*ECONOMICS  *HIV-1  Insurance,
       Health/*CLASSIFICATION  Male  Pneumonia, Pneumocystis carinii/PREVENTION
       & CONTROL  Prospective Studies  San Francisco  Zidovudine/THERAPEUTIC
       USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

