Improving access to health care among the poor--the neighborhood health center experience.

Utilization, cost, and productivity patterns at neighborhood health centers (NHCs) are examined on the basis of data from 82 centers. Minority groups and residents of the South and rural areas are found to have achieved levels of care and benefits closer to equality with other groups at NHCs than has been their health care experience generally. Continuity and comprehensiveness of care and the use of paramedical personnel are shown to be important contributory factors to utilization of NHCs. The impact of alternative cost-saving devices at NHCs is considered. It appears unlikely that professional productivity can be markedly improved. Increasing third-party payments is the most likely means of reducing dependence on operating grants without deleterious effects on utilization. The problem NHCs have had in maintaining stable professional staffs is shown to be a problem which needs further attention if the program is to expand.