The effects of social characteristics on the utilization of preventive medical services in contrasting health care programs.

This study, based on household interviews of employed individuals and their families, examines the effects of type of health insurance program and various sociodemographic factors on patterns of use of preventive medical services. A major concern of the paper is to explore the issue of whether participants in prepaid group practice use preventive services more than those in alternative insurance plans. The results show little differences in utilization among subscribers in a prepaid group plan as compared with a comparable sample of those in Blue Cross-Surgical Care plans. However, children in the prepaid plan, as compared with those in the more traditional Blue Cross plans, were more likely to receive general checkups and tuberculin skin tests in the prior year. Contrary to expectations, we found that in the employed population studied, black adults reported more preventive medical utilization than whites, and the black-white difference was the strongest single sociodemographic correlate of adult utilization of preventive care. The reporting of general checkups for children was highest among single-child families, for children under five years of age, and for those with better educated parents.