ECONOMIC IMPACT ON DECISION MAKING

Abstract

Circumcision in the patient population is not frequently performed for religious reasons. Its routine performance is discouraged as being medically unnecessary by written and verbal material provided to the mothers after delivery. Prior to September 1 1982 routine circumcision was provided without cost for medically indigent and public assistant patients at our facility. From that time until January 15 1983 a co-payment of $75.00 was required. After that time the original policy was re-established. No statistically significant effect was noted on the decision of parents to have their infant undergo this procedure in Hispanic (33/237, 13.6%) or Asian populations (11/84, 13.1%). However, the white population produced a significant decrease in incidence during the period of co-payment (37/56 v. 19/57 v. 53/72: x² = 21.1, p<.001). Approximately half of the parents were dissuaded by the financial requirements. Of these, few obtained circumcisions subsequently. Requiring co-payments for this elective procedure may produce a decrease in over $6 million of medical expenses in California state.

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