Andersen R, Aday L A
Med Care. 1978 Jul;16(7):533-46. doi: 10.1097/00005650-197807000-00001.
This paper seeks to provide a framework for understanding differential access to medical care in the U.S. population and to suggest ways to achieve equity of access. The framework is provided by a behavioral model of health services utilization which suggests a sequence of predisposing, enabling and illness variables that determine the number of times people will visit a physician. The model is operationalized using a path analytic technique. The data come from a national survey of the noninstitutionalized U.S. population conducted in late 1975 and early 1976. The results suggest services are generally equitably distributed since age and level of illness are the main determinants of the number of services people receive. However, remaining inequities might be reduced by providing people who report no regular source of medical care with a familiar entry into the health service system.
本文旨在提供一个框架，以理解美国人口在获得医疗服务方面的差异，并提出实现公平获得医疗服务的方法。该框架由一个卫生服务利用行为模型提供，该模型提出了一系列先赋性、促成性和疾病变量，这些变量决定了人们看医生的次数。该模型通过路径分析技术进行操作。数据来自1975年末和1976年初对美国非机构化人口的全国性调查。结果表明，由于年龄和疾病程度是人们获得服务数量的主要决定因素，服务总体上分配公平。然而，通过为那些报告没有固定医疗服务来源的人提供一个熟悉的进入卫生服务系统的途径，可能会减少剩余的不公平现象。
