Access to medical care in a medically indigent population.
OBJECTIVE
To study nature and extent of barriers to access to medical care in a single county and to define the nature of the illnesses in a population affected by those barriers.


METHODS
Descriptive study of consecutive patients not able to obtain medical care because of financial or other barriers. Financial barriers and medical diagnoses were categorized and the severity of illness and impact of unavailability of medical services were judged by a panel of internists using consensus analysis. The likelihood of obtaining care after refusal of assistance was also evaluated.


METHODS
A social services eligibility office on the grounds of an urban, university teaching hospital that serves a largely medically indigent population.


METHODS
200 patients who presented to eligibility workers seeking financial assistance.


METHODS
None.


RESULTS
Sixty percent could not obtain care because they were illegal aliens, 40% could not obtain care because they did not meet the strict criteria of the assistance programs. Sixty percent of patients had a moderate to high likelihood of long-term disability from their illnesses; 38% of a subgroup were not able to find care four weeks after entering the study, and these patients appeared to have more severe disease than those who were able to find care.


CONCLUSIONS
Many medically indigent persons with significant illnesses face serious financial barriers to access to medical care.
Akin
B V
BV
Division of General Internal Medicine and Primary Care, University of California Irvine Medical Center, Orange 92668-6836.
Rucker
L
L
Hubbell
F A
FA
Cygan
R W
RW
Waitzkin
H
H
D002140:California; D003365:Costs and Cost Analysis; D004608:Eligibility Determination; D004641:Emigration and Immigration; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006630:Hispanic or Latino; D006801:Humans; D007182:Income; D007348:Insurance, Health; D007843:Latin America / Q000208:ethnology; D008297:Male; D008483:Medical Assistance / Q000191:economics; D008489:Medical Indigency / Q000191:economics*; D008800:Mexico / Q000208:ethnology