After-hours physician access associated with lower patient expenditures

Patients who could visit their doctors on nights and weekends spent 10% less on health care than those without extended-hours access, a study found.

Researchers analyzed data from more than 33,000 people age 18 to 90 who responded to the 2000-2008 Medical Expenditure Panel Surveys. Respondents answered yes or no to having access to extended hours from a usual source of care in two successive years.

Results appeared in the September/October Annals of Family Medicine.

Total expenditures were 10.4% lower (95% CI, 7.2% to 13.4%) among patients reporting access to extended hours in both years compared to those who had it neither year. Adjustment for year 2 prescription drug expenditures and, to a lesser extent, office visit-related expenditures (but not total prescriptions or office visits, or emergency and inpatient expenditures) attenuated this relationship.

Although patients reporting access to extended hours were less likely to visit the emergency department, this didn't account for lower expenditures, since such visits were a small part of overall health care costs in year 2 of the study, the researchers noted. Instead, after-hours access may be a marker of primary care practices that take a cost-conscious approach. Also, practices offering extended access may attract patients less likely to seek brand-name drugs and discretionary testing, the researchers said.