Wolfe B L
Med Care. 1980 Dec;18(12):1196-207. doi: 10.1097/00005650-198012000-00005.
Children's utilization of medical care remains unequal even after the implementation of policies such as Medicaid and Neighborhood Health Centers. Children in lower-income areas or from larger families are less likely to see a provider over a 1-year period. Sharper differences are found when one analyzes the type of providers used. Here income, race, marital status, family type, type of insurance coverage and community characteristics are all associated with type of provider used. Children to whom more resources are available (in terms of income, parents' time, community income and insurance) appear more likely than other children to use what is traditionally termed higher-quality care. The fact that the data used are from a community with generous Medicaid benefits and a university-sponsored pediatric project suggests that inequalities in utilization continue to exist even after substantial government intervention.
即使实施了医疗补助计划和社区健康中心等政策,儿童在医疗护理的使用上仍然存在不平等现象。低收入地区或大家庭中的儿童在一年时间里看医生的可能性较小。在分析所使用的医疗服务提供者类型时,会发现更明显的差异。在这里,收入、种族、婚姻状况、家庭类型、保险覆盖类型和社区特征都与所使用的医疗服务提供者类型有关。相比其他儿童,有更多资源可用(在收入、父母时间、社区收入和保险方面)的儿童似乎更有可能使用传统上所谓的高质量医疗服务。所使用的数据来自一个有慷慨医疗补助福利的社区以及一个大学赞助的儿科项目,这一事实表明,即使在政府进行大量干预之后,医疗服务使用方面的不平等现象仍然存在。