Aday L A, Andersen R M
Am J Public Health. 1984 Dec;74(12):1331-9. doi: 10.2105/ajph.74.12.1331.
This paper presents analyses of recent national survey data on access to medical care. In particular, information on major access indicators and special problems associated with the economic and political climate of the 1980s collected in a 1982 national telephone survey of 6,610 United States adults and children, representing some 4,802 families, is compared with previous national surveys for key population subgroups--by age, place of residence, income, race, insurance coverage, and type of regular source of care. In general, the findings show that favorable progress has been made, but some inequities continue to persist. Some traditionally disadvantaged groups are more likely to have a regular family doctor, private insurance coverage, have been to a doctor, or had certain preventive tests and procedures than was true for them in the past. On the other hand, compared to the more economically and/or socially advantaged groups in 1982, they have still not "caught up" entirely. There also is evidence that they may be hardest hit by the exacerbation of the financial barriers to care that result from unemployment, inflation, and cutbacks in health program eligibility and benefits that have characterized the decade of the 1980s.
本文介绍了对近期有关医疗服务可及性的全国性调查数据的分析。具体而言,将1982年对6610名美国成年人及儿童(代表约4802个家庭)进行的全国性电话调查中收集到的关于主要可及性指标以及与20世纪80年代经济和政治气候相关的特殊问题的信息,与之前针对关键人口亚组(按年龄、居住地点、收入、种族、保险覆盖范围和常规医疗服务来源类型划分)的全国性调查进行比较。总体而言,研究结果表明已取得了良好进展,但一些不公平现象仍然存在。一些传统上处于不利地位的群体比过去更有可能拥有一名常规家庭医生、享有私人保险、看过医生或接受过某些预防性检查和程序。另一方面,与1982年经济和/或社会地位更优越的群体相比,他们仍未完全“赶上”。也有证据表明,他们可能受到因失业、通货膨胀以及20世纪80年代这十年所特有的健康计划资格和福利削减而导致的医疗财务障碍加剧的影响最为严重。