Health Care Utilization by Low-Income Clients of a Community Clinic: An Archival Study

An archival study was done of 500 medical records from a community clinic serving a low-income predominantly Hispanic area of Los Angeles. Data collected included demographic characteristics and presenting symptoms or reasons for visit, as well as diagnoses and treatment. Patients tended to be young, poor, female Hispanics. The majority of patient visits were for family planning services, with smaller proportions for pediatric, general medical, or pregnancy testing services. Return rates for family planning and other services were not as high as desirable, with more than half of the sample having made only one clinic visit. A careful analysis of the demographic characteristics of oral contraceptive acceptors who returned or did not return for services indicated that the two groups were similar to each other except that married women were more likely to return than single women. One quarter of positive pregnancy tests were done on women who were more than 12 weeks pregnant, while another quarter of positive tests were referred for abortion. The data highlighted certain changes needed in service delivery, such as the need for a pre- and postnatal care component of service and a need to attract more older and male patients. In the future, collection of archival data from this same clinic could facilitate the evaluation of certain policy changes, since those data could be compared with the present findings.