Access to medical care: the impact of outreach services on enrollees of a prepaid health insurance program.

Outreach services have been introduced in many programs designed to increase the access of the poor to medical care, but few controlled studies have examined the impact of the outreach programs on access. Here, low income families enrolled in a dual choice health insurance program offering very comprehensive benefits were assigned at random to two groups. Both groups received free medical care and, in addition, one group received outreach services. Comparison of the families after one year showed that the outreach group was significantly more likely to utilize and to report utilization, more likely to have physical examinations, and more likely to know about and utilize support services. Differences in these areas were generally small, and were more pronounced for minority families than for white families. Extension of the findings to other disadvantaged groups is discussed.