The association of access to medical care with regular source of care and sociodemographic characteristics in patients with HIV and tuberculosis.
OBJECTIVE
To examine satisfaction with access to health care in two populations, one with HIV and one with TB, and examine the effect of having a regular doctor and sociodemographic characteristics.


METHODS
Cross-Sectional survey.


METHODS
A sample of HIV inpatients hospitalized at seven Los Angeles sites (N = 217) and TB outpatients chosen randomly from the Los Angeles County TB Registry Census (N = 313).


METHODS
We performed bivariate and multivariate regression analyses of satisfaction with access to care on gender, race/ethnicity, age, education, income, insurance, and having a regular doctor.


METHODS
A six-item scale of satisfaction with access to care (range 0-100; Cronbach's alpha 0.87).


RESULTS
The mean satisfaction with access score for the HIV sample was significantly lower than the TB sample (53.5 vs. 61.2, p<0.001). The HIV sample multivariate analysis (including all the variables) showed that increasing age (p<0.021 and having a regular doctor (p<0.002) were associated with better access, and that low income (p<0.005) was associated with poor access. In the TB sample analysis, only increasing age was associated with better satisfaction with access to care (p< 0.01).


CONCLUSIONS
HIV patients receiving care in the private sector reported less satisfaction with access to care compared to TB patients receiving care in the public health sector. The traditional factors of socio-economic status and having a regular doctor were associated with satisfaction with access-to-care in the HIV sample but not the TB sample. Our findings suggest that certain characteristics of the TB public health programs may explain these differences and suggests that, perhaps, the existence of a similar public health program for vulnerable low-income populations with HIV would improve their satisfaction with access, as well.
UCLA Department of Family Medicine, West Los Angeles Veteran's Affairs Medical Center, USA.
M Rosa
MR
Solorio
Steven M
SM
Asch
Denise
D
Globe
William E
WE
Cunningham
D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D015141:Los Angeles; D017060:Patient Satisfaction; D017149:Private Sector; D011634:Public Health; D012923:Social Class; D014376:Tuberculosis / Q000628:therapy*