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Managed Care and Physicians' Provision of Charity Care Journal of the American Medical Association |
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Pressures on the Health Care Safety Net: Health Services Research |
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Ability to Obtain Medical Care for the Uninsured Journal of the American Medical Association |
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A Changing Picture of Uncompensated Care Health Affairs |
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| March 1999 Research Report No. 03 |
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Ability to Obtain Medical Care for the Uninsured
September 9, 1998
Journal of the American Medical Association, vol.280, no.10 (September 9, 1998): 921-927
Peter J. Cunningham, Peter Kemper
ecause communities differ in the way medical care for the indigent is
organized and delivered, there are likely to be differences in the ability of the
uninsured to obtain medical care. The authors analyzed the 1996-1997 Community Tracking
Study Household Survey, which included a random sample of 60 communities nationwide. The
survey represented 60,446 individuals in these communities, of whom 7,200 were uninsured.
Results of the analysis showed a twofold difference across communities in the ability of
the uninsured to obtain medical care, indicating that place of residence is an important
determinant in access to care. Most of the difference in access remained even when
controlling for health status and other individual characteristics. Despite these
differences, additional analysis showed that expanding insurance would do more to improve
access for the uninsured across all communities, compared to expanding the direct delivery
of services. Place of residence is likely to remain an important factor because provision
of medical care for the uninsured is driven largely by state and local policy.
Free access to this article is available at the Journal of the American Medical Association Web site.
