Accessibility of primary care services in safety net clinics in New York City.
OBJECTIVE
This study analyzed data from a survey of New York City ambulatory care facilities to determine primary care accessibility for low-income patients, as evidenced by the availability of enabling services, after-hours coverage, and policies for serving the uninsured.


METHODS
Ambulatory care facilities were surveyed in 1997, and analysis was performed on a set of measures related to access to care. Only sites that provided comprehensive primary care services were included in the analysis. For comparison, site were classified by sponsorship (public, nonprofit voluntary hospital, federally qualified health center, non-hospital-sponsored community health center).


RESULTS
Publicly sponsored sites and federally qualified health center sites showed the strongest performance across nearly all the measures of accessibility that were examined.


CONCLUSIONS
As safety net clinics confront the financial strain of implementing mandatory Medicaid managed care while also dealing with declining Medicaid caseloads and increasing numbers of uninsured, their ability to sustain the policies and services that support primary care accessibility may be threatened.
Weiss
E
E
United Hospital Fund, 350 Fifth Ave, 23rd Floor, New York, NY 10118-2399, USA.
Haslanger
K
K
Cantor
J C
JC
D003144:Communication Barriers; D003151:Community Health Centers / Q000458:organization & administration* / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005249:Fees and Charges; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006788:Hospitals, Voluntary / Q000706:statistics & numerical data; D006801:Humans; D007802:Language; D008329:Managed Care Programs; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured; D009519:New York City; D016134:Organizational Policy; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D011203:Poverty; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data