Newacheck P W
Institute for Health Policy Studies, University of California, San Francisco 94143.
Health Serv Res. 1988 Aug;23(3):401-19.
Studies conducted during the 1970s have reported conflicting results concerning whether differences in use of physician services between poor and nonpoor persons have been eliminated. Using a sample of 92,737 persons from the 1982 National Health Interview Survey and a refined analytic method, this study reexamines utilization of ambulatory care services by persons above and below the poverty level. Before adjusting for health status, no differences were apparent in rates of physician contacts for persons above and below the poverty level. After adjusting for health status, persons below poverty were shown to have significantly fewer physician contacts than persons above poverty. Multivariate analysis revealed that Medicaid coverage can effectively counter the depressing effects of poverty on use of physician services. However, only 34 percent of the noninstitutionalized population below poverty level had Medicaid coverage in 1982. Public policy implications concerning Medicaid eligibility criteria are discussed.
20世纪70年代进行的研究报告了关于贫困人群和非贫困人群在使用医生服务方面的差异是否已消除的相互矛盾的结果。本研究使用了1982年全国健康访谈调查中的92737人的样本以及一种改进的分析方法，重新审视了贫困线以上和以下人群对门诊护理服务的利用情况。在调整健康状况之前，贫困线以上和以下人群的医生就诊率没有明显差异。在调整健康状况之后，贫困人群的医生就诊次数明显少于非贫困人群。多变量分析显示，医疗补助覆盖能够有效抵消贫困对使用医生服务的抑制作用。然而，1982年贫困线以下的非机构化人口中只有34%享有医疗补助覆盖。文中讨论了有关医疗补助资格标准的公共政策含义。
