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Effects of Income, Insurance, and Source of Care

Ernest Moy, MD, MPH; Barbara A. Bartman, MD, MPH; Matthew R. Weir, MD

Arch Intern Med. 1995;155(14):1497-1502.

Abstract
Background
This study examines the relationship between income, health insurance, and usual source of care characteristics and screening and management of hypertension.

Methods
This is a secondary analysis of data from the 1987 National Medical Expenditure Survey. Adult survey respondents constitute a sample representative of the total adult noninstitutionalized US population. Screening, follow-up care, and pharmacologic treatment for hypertension were examined among low income individuals, the uninsured, those without a usual source of care place, and those without a particular usual source of care physician.

Results
The uninsured, individuals without a usual source of care place, and those without a particular usual source of care physician received less screening, follow-up care, and pharmacologic treatment for hypertension. Income did not affect receipt of hypertensive care.

Conclusions
Lack of health insurance and lack of a usual source of care are barriers to hypertensive care. Policies that increase access to health insurance or to usual source of care physicians may enable more individuals to attain control of hypertension.

(Arch Intern Med. 1995;155:1497-1502)

Author Affiliations
From the Divisions of General Internal Medicine (Drs Moy and Bartman) and Nephrology (Dr Weir), Departments of Medicine (Drs Moy, Bartman, and Weir) and Epidemiology and Preventive Medicine (Dr Bartman), University of Maryland School of Medicine, and the Veterans Affairs Medical Center (Drs Moy and Bartman), Baltimore, Md.

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