Equity concerns with the use of hospital services by the medically vulnerable

This study assessed distributional inequities in access to care among a representative sample of adults residing in Oklahoma. Inequities were identified by comparing the medically vulnerable to the less vulnerable with respect to their use or nonuse of hospital care and, among those admitted, the number of days of care consumed. The behavioral model was employed to guide the analysis and the development of hypotheses. Controlling for need, enabling, and predisposing factors, the results indicate that the use of service by the poor, the elderly who lack supplemental insurance, and the uninsured is incongruent with their health status and that current methods of financing care may contribute to distributional inequities. The implications of these findings are discussed in the context of options that may improve access to care by the medically vulnerable.