Social class differences in utilization of pediatric services in a prepaid direct service medical care program.

Abstract

A study of all children visiting the Kaiser Foundation Health Plan pediatric clinics at Oakland, California during a 4 day period in June, 1964, revealed that the elimination of economic barriers via prepayment for services did not result in equality of utilization of services for white and non-white populations. Whites regardless of social class divided their visits almost equally between the appointment and drop-in clinics. Negroes, who in this study group were concentrated in the lower social classes, visited primarily the drop-in clinics and made a smaller proportion of their visits for preventive services. There were no significant ethnic or social class differences related to the time of the visit. However, 53% of those making weekday evening visits to the drop-in clinics had a transportation problem compared to 22% of those making daytime visits. The study findings support the general contention that group health centers may have to adopt more effective methods to overcome the resistance of lower social classes and ethnic minorities to make better use of services for which they have already paid.