Changes in access to care, 1977-1996: the role of health insurance.
OBJECTIVE
To describe changes in Americans' access to care over the last 20 years focusing on the uninsured, Hispanic American, and young adult populations, and to analyze the factors underlying these changes with a particular focus on the role of health insurance.


METHODS
Data from the 1977 National Medical Care Expenditure Survey, the 1987 National Medical Expenditure Survey, and the 1996 Medical Expenditure Panel Survey.


METHODS
Focusing on whether each individual has a usual source of health care, we present descriptive statistics and algebraic decompositions.


METHODS
We combine data from the household surveys with questions from access to care supplements that were administered each time.


RESULTS
Hispanic Americans and young adults age 18-24 are more likely to lack a usual source of care than other Americans; these inequalities increased over the period studied and cannot be explained solely by changes in health insurance coverage.


CONCLUSIONS
Although increasing health insurance coverage will likely improve access to care among Hispanics and young adults, our findings suggest that the expansion of insurance coverage will not be sufficient to eliminate current disparities in access to care.
Zuvekas
S H
SH
Center for Cost and Financing Studies, Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
Weinick
R M
RM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data / Q000639:trends; D007348:Insurance, Health / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States