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Obstacles predicting lack of a regular provider and delays in seeking care for patients at an urban public hospital.
- Source :
-
JAMA [JAMA] 1994 Jun 22-29; Vol. 271 (24), pp. 1931-3. - Publication Year :
- 1994
-
Abstract
- Objective: To determine the correlation among obstacles to medical care, lack of a regular source of care, and delays in seeking care.<br />Design: Cross-sectional survey of patients presenting for ambulatory care during a 7-day period. Multiple logistic regression models were used to identify obstacles independently associated with outcome variables.<br />Setting: Urban public hospital.<br />Patients: A total of 3897 disadvantaged and predominantly minority patients.<br />Main Outcome Measures: Lack of a regular source of medical care and delay in seeking medical care for a new problem.<br />Results: The majority (61.6%) of patients reported no regular source of care. Of 2341 patients reporting a new medical problem, 48.4% waited more than 2 days before seeking medical care. No health insurance (adjusted odds ratio [OR], 2.2; 95% confidence interval [CI], 1.89 to 2.61), no transportation (OR, 1.44; 95% CI, 1.23 to 1.70), exposure to violence (OR, 1.21; 95% CI, 1.08 to 1.45), and living in a supervised setting (OR, 1.50; 95% CI, 1.00 to 2.25) were independent predictors of lack of a regular source of care. No insurance (OR, 1.24; 95% CI, 1.02 to 1.51), no transportation (OR, 1.45; 95% CI, 1.19 to 1.77), and less than a high school education (OR, 1.22; 95% CI, 1.08 to 1.49) were independent predictors of delaying care for a new medical problem.<br />Conclusions: Obstacles in addition to lack of insurance impede provision of medical care to disadvantaged patients. The adoption of universal health care coverage alone will not guarantee access to appropriate medical care.
- Subjects :
- Adolescent
Adult
Aged
Cross-Sectional Studies
Emergency Service, Hospital statistics & numerical data
Female
Georgia
Health Services Accessibility economics
Hospital Bed Capacity, 500 and over
Humans
Logistic Models
Male
Middle Aged
Minority Groups statistics & numerical data
Multivariate Analysis
Outpatient Clinics, Hospital statistics & numerical data
Socioeconomic Factors
Health Services Accessibility statistics & numerical data
Hospitals, Municipal statistics & numerical data
Patient Acceptance of Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0098-7484
- Volume :
- 271
- Issue :
- 24
- Database :
- MEDLINE
- Journal :
- JAMA
- Publication Type :
- Academic Journal
- Accession number :
- 8201737