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Assessing Use of Primary Health Care Services by Very Low-Income Adults in a Managed Care Program
Allison L. Diamant, MD, MSHS;
Robert H. Brook, MD, ScD;
Arlene Fink, PhD;
Lillian Gelberg, MD, MSPH
Arch Intern Med. 2001;161:1222-1227.
Objective To assess the effect of providing free health care services to low-income
adults.
Methods We measured access to primary care services by enrollees with 4 chronic
medical conditions in the General Relief Health Care Program (GRHCP), a program
designed for adults receiving General Relief (GR). Implemented by the Los
Angeles County Health Department in October 1995, the GRHCP is composed of
private and public health care facilities. As adults registered for GR, they
were asked to complete a baseline health survey, were enrolled in the GRHCP,
and assigned a health care provider. A total of 8520 surveys were completed
between September and November 1996 (98% response rate). The analyses of this
article are limited to individuals (N = 2164) who reported a history of hypertension,
diabetes mellitus, a nonresolving cough, or substance dependence. We reviewed
medical records to determine whether new GR recipients had visited their designated
GRHCP provider within 4 months of enrollment and used multivariate logistic
regression to assess the effect of individual patient factors on the use of
free health care.
Results A total of 17% of individuals visited their assigned GRHCP provider
within 4 months of enrollment. In multivariate analysis, patients were more
likely to have made a visit if they were younger than 50 years, were female,
were Asian/Pacific Islander, reported needing to see a physician, or had seen
a physician within 12 months.
Conclusions It is not sufficient to merely supply the name and address of a health
care provider to this population. More aggressive efforts should be attempted
to increase utilization of services for patients with medical conditions responsive
to ambulatory care.
From the Department of Medicine, Division of General Internal Medicine
and Health Services Research (Drs Diamant, Brook, and Fink), Department of
Medicine, Division of Geriatrics (Dr Brook), and Department of Family Medicine
(Dr Gelberg), UCLA, Los Angeles, Calif; and RAND-Health, Santa Monica, Calif
(Dr Brook).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Griswold et al.
J Am Board Fam Med 2005;18:166-172.
ABSTRACT
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