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Article
Insurance, income, and access to ambulatory care in King County, Washington
Meyers Primary Care Institute Publications and Presentations
  • Barry G. Saver, University of Massachusetts Medical School
  • Nancy Peterfreund, University of Washington
UMMS Affiliation
Meyers Primary Care Institute; Department of Family Medicine and Community Health
Date
11-1-1993
Document Type
Article
Medical Subject Headings
Adolescent; Adult; Aged; Ambulatory Care; Child; Data Collection; Female; Health Services Accessibility; Humans; Income; Insurance, Health; Linear Models; Male; Medicaid; Medically Uninsured; Middle Aged; Odds Ratio; Preventive Health Services; United States; Washington
Abstract
OBJECTIVES: We studied simultaneous effects of income and insurance on access measures in an indigent population, focusing on Medicaid and the marginal effects of increasing income. METHODS: Surveys were distributed in waiting rooms of county clinics and welfare offices. Models examined insurance (private, Medicaid, or none), income (to twice the poverty level), single-parent status, age, gender, and presence of a regular source of care; first-order interactions were evaluated. RESULTS: In terms of ease of access, postponing care, and having a regular source of care, uninsured respondents fared worst and Medicaid recipients were at an intermediate level. However, relative to those with private insurance, Medicaid recipients had four times the odds, and uninsured respondents twice the odds of being denied care. Income had no consistent effect; however, older, poorer people may have greater problems. For preventive services, income was significant, while differences between Medicaid and private insurance were generally not significant. CONCLUSIONS: Except for denial of care, access for indigent people is improved by Medicaid but remains worse than the access of those with private insurance. Income had variable effects, but support for income criteria used for public insurance eligibility was not found.
Comments

Citation: Am J Public Health. 1993 Nov;83(11):1583-8.

At the time of publication, Barry Saver was not yet affiliated with the University of Massachusetts Medical School.

Related Resources
Link to Article in PubMed
PubMed ID
8238683
Citation Information
Barry G. Saver and Nancy Peterfreund. "Insurance, income, and access to ambulatory care in King County, Washington" Vol. 83 Iss. 11 (1993) ISSN: 0090-0036 (Linking)
Available at: http://works.bepress.com/barry_saver/32/