title: Identifying affordable sources of medical care among uninsured persons.
abstract: OBJECTIVE
  To examine the effects of policy, health system, and sociodemographic characteristics on the likelihood that uninsured persons pay a lower price at their regular source of care, or that they are aware of lower priced providers in their community.
  
  
  METHODS
  The 2003 Community Tracking Study household survey, a nationally representative sample of the U.S. population and 60 randomly selected communities.
  
  
  METHODS
  The survey asked uninsured persons if they paid full or reduced cost at their usual source of medical care, or if they were aware of providers in their community that charge less for uninsured people. We use binomial and multinomial logistic regression analysis to examine the effects of various policy, health system, and sociodemographic characteristics on use and awareness of lower priced providers. We focus especially on the effects of safety-net capacity, measured by safety-net hospitals, community health centers, physicians' charity care, and Community Access Program (CAP) grants.
  
  
  RESULTS
  Less than half of the uninsured (47.5 percent) reported that they used or were aware of a lower priced provider in their community. Multivariate regression analysis shows that greater safety-net capacity is associated with a higher likelihood of having a lower priced provider as the regular source of care and greater awareness of lower priced providers. Lower incomes and racial/ethnic minorities also had a higher likelihood of having a lower priced provider, although health status did not have statistically significant effects.
  
  
  CONCLUSIONS
  Although increased safety-net capacity may lead to more uninsured having a lower priced provider, many uninsured who live near safety-net providers are not aware of their presence. Greater outreach designed to increase awareness may be needed in order to increase the effectiveness of safety-net providers in improving access to care for the uninsured.
authors.affiliation: Center for Studying Health System Change, 600 Maryland Ave., S.W., Suite 550, Washington, DC 20024, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Cunningham
authors.forename: Jack
authors.initials: J
authors.lastname: Hadley
authors.forename: Genevieve
authors.initials: G
authors.lastname: Kenney
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Davidoff
mesh_terms: D000293:Adolescent; D000328:Adult; D002608:Charities; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers / Q000191:economics; D004469:Economics, Hospital; D005194:Family Practice / Q000191:economics; D005260:Female; D005102:Health Expenditures; D006291:Health Policy; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics; D006764:Hospitals, Community / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D012959:Socioeconomic Factors