A co-payment for consultant services: Primary care physicians' referral actualization

Daniel A. Vardy, Tami Freud, Michael Sherf, Ofer Spilberg, Dan Goldfarb, Arnon D. Cohen, Shlomo Mor-Yosef, Pesach Shvartzman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Prospective evaluation of the effect of a new co-payment for specialists consultations on actualization of referrals (2,432 patient), was examined. Actualization of the appointment, reasons for not actualizing, and sociodemographic characteristics were recorded. Actualization was 85.1% in community consultation clinics and 91.7% in hospital outpatient clinics. The main reasons for non actualization were: inability to reach the clinic (53.4%), the problem had resolved (15%), and co-payment (2%). In addition, 19.1% stated that they did not actualize a past consultant visit due to co-payment. Referring physicians noted that co-payment had some effect on their decision, especially with the elderly or lower income patients. A relatively small compulsory co-payment was not found to have a long term effect on utilization of specialists' services.

Original languageEnglish
Pages (from-to)37-41
Number of pages5
JournalJournal of Medical Systems
Issue number1
StatePublished - 1 Feb 2008


  • Co-payment
  • Consultation
  • Exemption
  • Health services use

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Information Systems
  • Health Informatics
  • Health Information Management


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