Patterns of Hospital and Physician Utilization among the Uninsured

Despite numerous studies of access to care by the uninsured, few researchers have examined whether access to hospitals among the uninsured differs from access to physicians. This study employs a correlational, two-group design (n=102,055) to analyze cross-sectional data from the 1989 National Health Interview Survey. Multiple logistic regression was used to compare the likelihood of hospitalization for the uninsured and insured in chronically ill, acutely ill, and well nonelderly subpopulations. When compared to data from a previous study on physician visits, disparities in hospitalization among the three subgroups differed in both magnitude and relative order from disparities in physician visits. The disparities between the insured and uninsured clustered at 38 percent for hospitalization, and 20 percent for physician visits. Overall, being uninsured resulted in a larger difference for hospital utilization than for physician utilization. These findings suggest that the uninsured face even greater access barriers for hospitalization than they do for physician care.