December 27, 2019 / 8:22 PM / 24 days ago

Patients don't care about provider religious ties, expect all needed care

(Reuters Health) - Nearly three quarters of Americans don’t care about the religious affiliation of their hospital or healthcare network, but an equal number say they expect their healthcare preferences to take priority over the facility’s religious doctrine, a new study finds.

The survey comes at a time when the number of Catholic-owned healthcare systems are on the rise, researchers note. And, perhaps unknown to many patients, physicians at those facilities are expected to follow the U.S. Conference of Catholic Bishops’ “Ethical and Religious Directives for Catholic Health Care Services,” which places limits on reproductive and end-of-life care methods.

“We are seeing the composition of the U.S. healthcare system shifting,” said the study’s lead author, Dr. Maryam Guiahi, an associate professor in the department of obstetrics and gynecology and the center for bioethics at the University of Colorado School of Medicine, in Aurora.

“The number of Catholic-owned or affiliated healthcare facilities grew by 22% between 2001 and 2016,” Guiahi said. “And this contrasts with the overall number of acute-care hospitals, which decreased by 6% and the number of other nonprofit religious hospitals decreased by 38%. What this means is that increasingly more U.S patients will be seeking care in health facilities that may follow religious rules rather than evidence-based guidelines for care.”

Many patients may not realize that the religious affiliation of a healthcare system might impact the care they get, Guiahi said.

For example, “prior research has shown that the vast majority of religious-affiliated institutions offer birth control appointments, but in the office, the patient might find some of the most effective birth control methods are not offered,” she said. Healthcare providers at these institutions are, according to the religious guidelines, “only permitted to offer counseling on natural family planning to heterosexual families.”

Noting the increasing number of Catholic-owned facilities, Guiahi and her colleagues decided to find out what Americans’ preferences were when it comes to choosing a healthcare system.

The researchers created a national survey that was administered to 1,446 U.S. adults by NORC (formerly the National Opinion Research Center) in November 2017. The survey focused on patients’ views of religious institutional care, according to the report in JAMA Network Open.

Participants were asked about the most important factors in selecting healthcare facilities. Among the most common responses: the patient’s health insurance was accepted (72.5%), the clinicians’ reputation (60.2%), and the facility’s reputation (59.5%). Just 6.4% said they considered the religious affiliation of the healthcare institution.

When asked specifically whether they preferred a religious institution, 71.3% of participants said they didn’t care, 13.4% said they preferred one with a religious affiliation, and 15.3% said they preferred one with no affiliation.

Most participants (71.4%) agreed with the statement that their personal choices about their health should have priority over a healthcare facility’s religious affiliation and this was more common for women than men (74.9% versus 68.1%).

“This is an interesting survey,” said Dr. Albert Wu, an internist and a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

“On the one hand, it’s pretty clear from this survey that Americans don’t consider an institution’s religious affiliations when they need healthcare, especially when they are sick,” Wu said. “They assume they will get the needed healthcare regardless of affiliation.”

Unfortunately, Wu said, “most people are clueless to the fact that they should take into consideration the institution’s religious affiliation since there is a chance that certain types of care might be denied. In the worst-case scenario, the practices of some organizations are deceptive.”

It’s important that we have laws “that balance protections for religious institutions with patient protections,” Wu said. “We live in a pluralistic society and not a theocracy. The principle tenet of the medical profession is that the protections for the patient should outweigh those for the religious institution.”

SOURCE: bit.ly/353K318 and bit.ly/2tRVkop JAMA Network Open, online December 27, 2019.

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