Access to ambulatory care for poor persons

Studies conducted during the 1970s have reported conflicting results concerning whether differences in use of physician services between poor and nonpoor persons have been eliminated. Using a sample of 92,737 persons from the 1982 National Health Interview Survey and a refined analytic method, this study reexamines utilization of ambulatory care services by persons above and below the poverty level. Before adjusting for health status, no differences were apparent in rates of physician contacts for persons above and below the poverty level. After adjusting for health status, persons below poverty were shown to have significantly fewer physician contacts than persons above poverty. Multivariate analysis revealed that Medicaid coverage can effectively counter the depressing effects of poverty on use of physician services. However, only 34 percent of the noninstitutionalized population below poverty level had Medicaid coverage in 1982. Public policy implications concerning Medicaid eligibility criteria are discussed.