Comparing the Use of Medical Care Services by a Medically Indigent and a General Membership Population in a Comprehensive Prepaid Group Practice Program

The utilization of medical-care services by the general membership of a prepaid group practice program is compared with that of the participants of an OEO Comprehensive Neighborhood Health Center Program. This OEO program provides medical care for 1,500 urban indigent families by integrating them on a prepaid capitated basis into the Kaiser Foundation Health Plan in Portland, Oregon. Generally, the findings indicate that the rate and patterns of utilization between the two populations are essentially similar. The only major differences are: 1. that the adult males of the poverty population use a significantly higher rate of services with a high emotional component, and 2. that the poverty population fails to keep scheduled appointments at a significantly higher rate than the health plan members. The data indicate that much of the reported differences in medical care utilization between poverty groups and other sections of the general population seem to disappear when financial and other barriers are removed. Many of the reported differences in the behavior of poverty populations appear to relate to differential access to care.