Research Activities, May 2011: Outcomes/Effectiveness Research: Practice setting, ownership, and specialty all affect volume of charity care provided by physicians

Outcomes/Effectiveness Research
Practice setting, ownership, and specialty all affect volume of charity care provided by physicians

Charity care is a crucial source of health care for the uninsured, with private practice physicians providing upwards of 80 percent of all of the care delivered to the nation's uninsured. As the number of uninsured persons has grown, the percentage of physicians providing charity care nationwide has declined from 76.3 percent in 1996 to 68.2 percent in 2005. Among physicians providing any charity care, a higher hourly wage was associated with a greater amount of charity care, regardless of salaried status, according to Brad Wright, M.S., Ph.D. (Cand.), of the University of North Carolina at Chapel Hill. Physicians on average provided 10.7 hours of charity care in a month, with an average hourly wage of $82.68.

Wright combined 4 rounds of the Center for Studying Health System Change's Community Tracking Study, which yielded a sample of 43,866 physicians over a 9-year period. He found that, for both salaried and nonsalaried physicians, practice ownership and practice setting were stronger determinants than wage for providing charity care. Among salaried physicians, full owners were 14.9 percent more likely and part owners were 8.9 percent more likely than nonowners to provide charity care. Among salaried physicians, those working in group HMOs were 22.6 percent less likely to provide charity care. Among nonsalaried physicians working in group HMOs, there was a 17.7 percent decline in the likelihood of providing charity care. Also, emergency physicians were likely to provide less charity care and surgeons more such care than others. The study was supported by the Agency for Healthcare Research and Quality (T32 HS00032).

See "Time is money: Opportunity cost and physicians' provision of charity care 1996-2005," by Mr. Wright, in the December 2010 HSR: Health Services Research 45 (6), Part I, pp. 1670-1692.


Research Activities, May 2011: Outcomes/Effectiveness Research: Practice setting, ownership, and specialty all affect volume of charity care provided by physicians