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Curtis Stine

Publications and source records attributed to Curtis Stine.

3 recordsLinked to original sources
PubMed2005

The changing face of access to family physician services in rural Florida.

OBJECTIVES: This study's purpose was to determine whether access to services performed by Florida family physicians in rural areas is changing and whether the recent changes in the availability or cost of professional liability insurance may be influencing service provision. METHODS: We conducted a survey of all family physicians in rural Florida, asking about changes in health care services and procedures provided, insurance coverage and premiums, satisfaction with practice, and plans for future practice. RESULTS: Of the 204 respondents, 96 (49.5%) indicated that they have decreased or eliminated some health care services during the last year. Overall, 69.8% decreased or eliminated vaginal deliveries, 66.2% Cesarean sections, 56.6% endoscopies, 50.9% hospital-based surgeries, 50.7% emergency room coverage, 40.8% office-based surgeries, and 33.6% mental health services. Malpractice premiums increased a mean of 98.5%. Difficulty with finding or paying for insurance was listed as an important factor both by those reducing or eliminating services and by those planning to leave the community within the next 2 years. CONCLUSIONS: Access to some services provided by family physicians in rural areas is decreasing and may be influenced by recent changes in professional liability insurance costs and other factors in Florida. Given the number of states currently experiencing similar insurance cost changes, access to health care in rural areas may be affected nationwide.

Adult↗
PubMedDate not supplied

Continuing decline in service delivery for family physicians: is the malpractice crisis playing a role?

PURPOSE: This study was conducted to monitor trends in the reduction and elimination of services offered by family physicians. In addition, we examined whether the malpractice situation may be influencing these trends. METHODS: We surveyed all family physicians in rural Florida and an equal number of randomly selected, urban, family physicians in the state. We examined changes in professional liability insurance (PLI) premiums, and changes in services offered, practice satisfaction, and future practice plans. RESULTS: Overall, 308 (42.1%) family physicians responded. Results suggest that 60.3% of them reduced or eliminated services in the last year. Specifically, almost two thirds of respondents had eliminated hospital-based surgeries (65.2%) and vaginal deliveries (64.5%). Furthermore, endoscopies were decreased or eliminated by 69% of survey participants, and coverage of emergency departments and nursing homes was reduced or eliminated by 64.1% and 56.4% of respondents, respectively. Increases in the PLI averaged 78.2%. Overall increases in the PLI were significantly related to a decrease or elimination of services offered by family physicians. Dissatisfaction with practice was relatively high (36.8%) and was associated with both the reduction of services and an intention to leave practice within 2 years. No major differences in these trends were noted between rural and urban family physicians. CONCLUSIONS: Access to care provided by rural and urban family physicians in Florida is being hampered by the malpractice situation and other factors. Policymakers may need to focus on these factors in an effort to relieve additional barriers to care for vulnerable populations.

Adult↗