Assessing access constraints on system equity: source of care differences in the distribution of medical services.

This article shows how differences in source of care can affect the likelihood that a person will obtain the medical services that he or she requires. Previous work has shown that the setting where care is received can have important effects on the quality of the services that are provided. The present study extends this line of research to questions of system equity. Unlike prior work in the area, the present approach emphasizes systemic relations among different types of delivery sites as a means of formulating and testing alternative models of service delivery. Preliminary findings indicate significant differences in utilization patterns depending on whether one establishes contact in a physician's private office. The results of the study suggest the need for continued concern over the role of access constraints in determining service opportunities.