Abstract
Previous studies of medical care utilization have controlled for medical need by signs or symptoms or broad disease classifications. The present study uses both symptoms and discrete diagnoses to control for medical need in order to determine if the use of ambulatory and hospital care differs by race, income, education, insurance coverage, or region. Using data from the 1976 National Health Interview Survey, we found that there were no consistent differences in the number of physician visits made in a year by these characteristics, medical need held constant. Lack of insurance coverage was associated with fewer hospitalizations in a year for five of nine chronic diseases under review. Race was associated with fewer hospitalizations for two conditions prevalent among minorities. These effects were not evident when medical need was controlled solely by signs or symptoms.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chen M. K., Buck R. D. Measuring the health care needs of an adult population in California. Med Care. 1981 Apr;19(4):452–464. doi: 10.1097/00005650-198104000-00007. [DOI] [PubMed] [Google Scholar]
- Chen M. K. Measuring need for health services: a proposed model. Med Care. 1979 Feb;17(2):210–214. doi: 10.1097/00005650-197902000-00011. [DOI] [PubMed] [Google Scholar]
- Davis K., Gold M., Makuc D. Access to health care for the poor: does the gap remain? Annu Rev Public Health. 1981;2:159–182. doi: 10.1146/annurev.pu.02.050181.001111. [DOI] [PubMed] [Google Scholar]
- Dutton D. B. Explaining the low use of health services by the poor: costs, attitudes, or delivery systems? Am Sociol Rev. 1978 Jun;43(3):348–368. [PubMed] [Google Scholar]
- Kleinman J. C., Gold M., Makuc D. Use of ambulatory medical care by the poor: another look at equity. Med Care. 1981 Oct;19(10):1011–1029. doi: 10.1097/00005650-198110000-00004. [DOI] [PubMed] [Google Scholar]
- Rice D. P., Drury T. F., Mugge R. H. Household health interviews and minority health: the NCHS perspective. Med Care. 1980 Mar;18(3):327–335. doi: 10.1097/00005650-198003000-00007. [DOI] [PubMed] [Google Scholar]
- Salber E. J., Beza A. G. The health interview survey and minority health. Med Care. 1980 Mar;18(3):319–326. doi: 10.1097/00005650-198003000-00006. [DOI] [PubMed] [Google Scholar]