HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sox, C M Articles by Brennan, T A Search for Related Content PubMed PubMed Citation Articles by Sox, C M Articles by Brennan, T A

Insurance or a regular physician: which is the most powerful predictor of health care?

C M Sox, K Swartz, H R Burstin and T A Brennan

Department of Health Policy and Management, Harvard School of Public Health, Cambridge, Mass., USA.

OBJECTIVES: This study compared the relative effects on access to health care of relationship with a regular physician and insurance status. METHODS: The subjects were 1952 nonretired, non-Medicare patients aged 18 to 64 years who presented with 1 of 6 chief complaints to 5 academic hospital emergency departments in Boston and Cambridge, Mass, during a 1-month study period in 1995. Access to care was evaluated by 3 measures: delay in seeking care for the current complaint, no physician visit in the previous year, and no emergency department visit in the previous year. RESULTS: After clinical and socioeconomic characteristics were controlled, lacking a regular physician was a stronger, more consistent predictor than insurance status of delay in seeking care (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.2, 2.1), no physician visit [OR] = 4.5%, 95% CI = 3.3, 6.1), and no emergency department visit (OR = 1.8, 95% CI = 1.4, 2.4). For patients with a regular physician, access was no different between the uninsured and the privately insured. For privately insured patients, those with no regular physician had worse access than those with a regular physician. CONCLUSIONS: Among patients presenting to emergency departments, relationship with a regular physician is a stronger predictor than insurance status of access to care.

This article has been cited by other articles:

				S. Y. Angell, R. K. Garg, R. C. Gwynn, L. Bash, L. E. Thorpe, and T. R. Frieden Prevalence, Awareness, Treatment, and Predictors of Control of Hypertension in New York City Circ Cardiovasc Qual Outcomes, September 1, 2008; 1(1): 46 - 53. [Abstract] [Full Text] [PDF]

				M. Lillie-Blanton and C. Hoffman The Role Of Health Insurance Coverage In Reducing Racial/Ethnic Disparities In Health Care Health Aff., March 1, 2005; 24(2): 398 - 408. [Abstract] [Full Text] [PDF]

				K. J. Dombkowski, P. M. Lantz, and G. L. Freed Role of Health Insurance and a Usual Source of Medical Care in Age-Appropriate Vaccination Am J Public Health, June 1, 2004; 94(6): 960 - 966. [Abstract] [Full Text] [PDF]

				J. M. De Maeseneer, L. De Prins, C. Gosset, and J. Heyerick Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs? Ann. Fam. Med, September 1, 2003; 1(3): 144 - 148. [Abstract] [Full Text] [PDF]

				J. E. DeVoe, G. E. Fryer, R. Phillips, and L. Green Receipt of Preventive Care Among Adults: Insurance Status and Usual Source of Care Am J Public Health, May 1, 2003; 93(5): 786 - 791. [Abstract] [Full Text] [PDF]

				K. M. Brett and J. A. Higgins Hysterectomy Prevalence by Hispanic Ethnicity: Evidence From a National Survey Am J Public Health, February 1, 2003; 93(2): 307 - 312. [Abstract] [Full Text] [PDF]

				M. S. Donaldson Continuity of Care: A Reconceptualization Med Care Res Rev, September 1, 2001; 58(3): 255 - 290. [Abstract] [PDF]

				S. Lemon, J. Zapka, E. Puleo, R. Luckmann, and L. Chasan-Taber Colorectal Cancer Screening Participation: Comparisons With Mammography and Prostate-Specific Antigen Screening Am J Public Health, August 1, 2001; 91(8): 1264 - 1272. [Abstract] [Full Text] [PDF]

				S. Ryan, A. Riley, M. Kang, and B. Starfield The Effects of Regular Source of Care and Health Need on Medical Care Use Among Rural Adolescents Arch Pediatr Adolesc Med, February 1, 2001; 155(2): 184 - 190. [Abstract] [Full Text] [PDF]

				B. J. Turner, W. E. Cunningham, N. Duan, R. M. Andersen, M. F. Shapiro, S. A. Bozzette, T. Nakazono, S. Morton, S. Crystal, P. St Clair, et al. Delayed Medical Care After Diagnosis in a US National Probability Sample of Persons Infected With Human Immunodeficiency Virus Arch Intern Med, September 25, 2000; 160(17): 2614 - 2622. [Abstract] [Full Text] [PDF]

				J. M. Gill, A. G. Mainous III, and M. Nsereko The Effect of Continuity of Care on Emergency Department Use Arch Fam Med, April 1, 2000; 9(4): 333 - 338. [Abstract] [Full Text] [PDF]