Access to care among vulnerable populations enrolled in commercial HMOs.
This cross-sectional study compares self-reported access to care among a representative sample of 13,952 HMO enrollees in New Jersey. Using multivariate logistic regression, this study found that compared with college graduates, those with less than a high school education reported more difficulty obtaining tests or treatment. Compared with whites, Hispanics were more likely to report difficulty seeing their primary care provider, and African Americans reported greater difficulty seeing a specialist and obtaining tests and treatment. Enrollees in poor health were more likely to report problems seeing a specialist and obtaining tests and treatment than enrollees in excellent health. Income was not a consistent predictor of access. Nonfinancial barriers appear to be more influential than financial barriers for predicting access problems in commercial HMOs. More work is needed to identify the source of nonfinancial barriers to care among vulnerable populations.
Carlson
Matthew J
MJ
Portland State University, CareOregon, USA.
Blustein
Jan
J
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009515:New Jersey; D012044:Regression Analysis; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000208:ethnology / Q000706:statistics & numerical data*