Nycz G R, Wenzel F J, Lohrenz F N, Mitchell J H
Public Health Rep. 1976 Nov-Dec;91(6):504-7.
To determine the degree to which enrollees of the Greater Marshfield Community Health Plan were representative of the community the plan was designed to serve, a telephone survey of 1,838 households in the 30-township area was undertaken. The response rate was 93%, and data were obtained from 1,718 households containing 5,260 persons. Of these, 484 households had at least one health plan member. Since the plan accepts only persons under age 65, analysis of the data was limited to those persons aged 64 and younger. Results indicate that enrollees showed good representation of demographic variables such as age, sex, and relationship to the household head when they were compared to the under 65 population of the area. When the enrollee's socioeconomic characteristics (education, income, and occupation) were studied, it was found that, although enrollees showed good representation for most categories they tended to underrepresent the under 65 area population in the lowest income and education classes, as well as in the semiskilled or unskilled occupations. The opposite was true for the upper income and educational classes. Data on location of residence indicated that a strong relationship existed between enrollment and proximity to Marshfield, where the major health care center is located. The use of health services was found to be positively related to membership, with enrollees overrepresented among those with recent hospital or physician contacts. The ability to obtain coverage through employment or by other means was found not to be related to membership. Satisfaction as expressed by participants was much higher in the prepaid program than among those with other forms of coverage.
为了确定大沼泽地社区健康计划的参保者在多大程度上代表了该计划旨在服务的社区,对30个镇区的1838户家庭进行了电话调查。回复率为93%,从1718户家庭(共5260人)获取了数据。其中,484户家庭至少有一名健康计划成员。由于该计划仅接纳65岁以下的人员,因此数据分析仅限于64岁及以下的人员。结果表明,与该地区65岁以下的人口相比,参保者在年龄、性别以及与户主的关系等人口统计学变量方面具有良好的代表性。在研究参保者的社会经济特征(教育程度、收入和职业)时发现,尽管参保者在大多数类别中具有良好的代表性,但在收入和教育水平最低的类别以及半熟练或非熟练职业中,他们在该地区65岁以下人口中的代表性往往不足。在高收入和高教育水平类别中情况则相反。关于居住地点的数据表明,参保与距离主要医疗中心所在地马什菲尔德的远近之间存在密切关系。研究发现,医疗服务的使用与参保呈正相关,在最近有过住院或看医生经历的人群中,参保者的比例过高。通过就业或其他方式获得保险的能力与参保无关。参与者表示,预付计划的满意度远高于其他形式保险的满意度。