Out-of-pocket payments and use of care for serious and minor symptoms. Results of a national survey.

To assess the effect of out-of-pocket payments on use of care for symptoms that physicians consider serious and meriting care, and for minor symptoms, we evaluated data from a 1986 national survey. Among 5412 adults reporting one or more medical visits in the last year, 18.8% had experienced serious symptoms within the previous 30 days, among whom 63.0% sought care, while 31.3% had experienced minor symptoms, among whom 42.8% sought care. Subjects who had paid $15 or less out of pocket for their last medical visit were more likely to seek care for a serious symptom (67.1% vs 52.6%) or for a minor symptom (47.1% vs 32.2%) than were those who paid $30 or more. Large out-of-pocket payments are associated with significant reductions in use of care for both serious and minor symptoms.