Determinants of Medical Care Utilization

This paper tests the notion that social class will measure differences in patterns of entry into the medical care process and that entry patterns will be affected by distances. The study was made using a 5 per cent sample of the Kaiser Foundation Health Plan membership of the Portland, Oregon S.M.S.A. in 1967. The population was dichotomized into working class and middle class on the basis of occupation. The working class was made up of machine operators and unskilled employees and the balance of the population comprised the middle class. Distance was determined in miles from residence to the nearest Kaiser facility. The data indicate that social class differentiates patterns of entry into the medical care system, but that when total initial contacts for each social class are examined by distance intervals, further differences emerge. The study, therefore, suggests that distance affects the medical care process differentially by social class and interacts with social class as an explanatory variable.