Determinants of health provider selection in a West Dallas, Mexican-American community

The focus of health policy has shifted since the late 1970s from emphasizing "equal access" to now considering cost-efficiency in health care as vital. This paper analyzes factors related to the selection of a health provider in a low-income community in West Dallas, Texas. Specifically, it looks at two sets of characteristics (population at risk and health provision system) as they influence the choice of hospital outpatient services as a source of health care. When subjected to multivariate analysis, it was found that health system characteristics, and convenience measures in particular, had the greatest impact on consumers' choice of these services. The notion of "equity" for future health planners concerned with providing services to low-income communities will best be served by the more efficient use of existing hospital clinics rather than by continuing to provide health care systems that serve the poor exclusively.