Okada L M, Sparer G
J Community Health. 1976 Spring;1(3):163-74. doi: 10.1007/BF01323107.
In terms of less access to private sources of care (as distinguished from hospital-public clinics) and longer travel time to usual source of care, poverty areas are at a disadvantage. Within the ten areas studied, the poor have less access than the nonpoor, with access differences even greater between the races than between income groups. Blacks generally have less than whites when income differences are taken into account. Both the type of usual source of care and travel time appear to be related to differential utilizations of ambulatory care resources: persons reporting private sources of care and persons with shorter travel time to their usual source of care tend to make more physician visits in a year. Mechanisms for public financing of health care will not likely alleviate the problems of inaccessibility presented by poverty areas. It is in these areas of low access that public responsibility to organize and locate facilities will continue even after the advent of a fairly comprehensive payment mechanism for health care among the poor.
在获得私人医疗资源（区别于医院-公共诊所）的机会较少以及前往常规医疗服务机构的路途时间较长方面，贫困地区处于劣势。在所研究的十个地区中，贫困人口获得医疗服务的机会比非贫困人口少，而且种族之间的机会差异比收入群体之间的差异更大。考虑到收入差异，黑人获得医疗服务的机会通常比白人少。常规医疗服务机构的类型和路途时间似乎都与门诊医疗资源的不同利用情况有关：报告使用私人医疗资源的人和前往常规医疗服务机构路途时间较短的人在一年中看医生的次数往往更多。医疗保健的公共融资机制不太可能缓解贫困地区存在的难以获得医疗服务的问题。即使在为贫困人口建立了相当全面的医疗保健支付机制之后，在这些难以获得医疗服务的地区，公共部门组织和选址医疗机构的责任仍将继续存在。
