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Abstract: This paper presents analyses of recent natioanl survey data on access to medical care. In particular, information on major access indicators and special problems associated with the economic and political climate of the 1980s collected in a 1982 national telephone survey of 6.610 United Scales adults and children, representing some 4.802 families, is compared with previous national stirrers for kef population subgroups--by age. place of residence, income, race, insurance coverage, and type of regular source of care In general, the findings show that favorable progress has been made, but some inequities continue to persist. Some traditionally disadvantaged groups are more likely to have a regular family doctor, private insurance coverage, have been to a doctor, or had certain preventive tests and procedures than was true for them in the past. On the other hand, compared to the more economically and/or socially advantaged groups in 1982, they have still not "caught up" entirely. There also is evidence that they may be hardest hit by the exacerbation of the financial barriers to care thai result from unemployment, inflation, and cutbacks in health program eligibility and benefits that have characterized the decade of the 1980s. [ABSTRACT FROM AUTHOR]

During a three-month period, all admissions to an infectious disease ward at a tertiary care hospital in the People's Republic of China were studied. The hospital's catchment area covered a population of almost eight million. 10 per cent urban and 90 per cent rural. Seventy-two per cent of the patients admitted to this facility were city dwellers with illnesses which were significantly less serious in degree than the illnesses encountered among patients transferred from rural facilities. Ease of travel, nature Of the disease process, availability of beds. ability to manipulate the referral ladder, and cost of health care may account for these results. Charges for health care in China proved very expensive relative to per capita income. This may be of major consequence to rural persons who are personally liable for some portion of this cost. These results suggest that although referral to tertiary care in China occurs more commonly among rural patients than is the case in other developing nations, access to this care and its cost are significant problems of the present system. During the drive for modernization, a multifactorial approach (including health policy, administrative controls, and patient and physician education) will be essential to avoid deterioration of the rural health system, and the increased financial burden to be expected with the introduction of advanced medical technology, (Am J Public Health 1982: 72: 1238--1245.) [ABSTRACT FROM AUTHOR]

The article discusses the health and social circumstances surrounding the use of a hospital emergency room in a suburban, semi-rural area by families with and without their own primary care physicians to define needed changes in hospital policy and procedures. The data suggest that certain strategies that have been proposed for dealing with the crisis in the volume and in the urgent, non-urgent mix of hospital emergency room use may have limited applicability to hospital-community situations. The accessibility of the hospital emergency room serves to supplement the limited range and availability of services that solo practitioners can provide.