This study compared the relative effects on access to health care of relationship with a regular physician and insurance status.
The subjects were 1952 nonretired, non-Medicare patients aged 18 to 64 years who presented with 1 of 6 chief complaints to 5 academic hospital emergency departments in Boston and Cambridge, Mass, during a 1-month study period in 1995.
Access to care was evaluated by 3 measures : delay in seeking care for the current complaint, no physician visit in the previous year, and no emergency department visit in the previous year.
After clinical and socioeconomic characteristics were controlled, lacking a regular physician was a stronger, more consistent predictor than insurance status of delay in seeking care (odds ratio [OR]=1.6,95% confidence interval [CI]=1.2,2.1), no physician visit (OR=4.5,95% CI=3.3,6.1), and no emergency department visit (OR=1.8,95% CI=1.4,2.4).
For patients with a regular physician, access was no different between the uninsured and the privately insured.
For privately insured patients, those with no regular physician had worse access than those with a regular physician.
Among patients presenting to emergency departments, relationship with a regular physician is a stronger predictor than insurance status of access to care.
Mots-clés Pascal : Accessibilité, Soin, Facteur prédictif, Médecin, Personnel sanitaire, Consultation, Assurance maladie, Homme, Massachusetts, Etats Unis, Amérique du Nord, Amérique, Médecin famille, Consultation régulière
Mots-clés Pascal anglais : Accessibility, Care, Predictive factor, Physician, Health staff, Consultation, Health insurance, Human, Massachusetts, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0196257
Code Inist : 002B30A01B. Création : 11/09/1998.