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Barbara Starfield, MD, MPH

JAMA. 1995;274(4):346-347.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

If health services have any value, then access to them must be important. The many research studies directed at demonstrating something so obvious as the value of access are testimony to concern about a health care system that does not ensure its universality.

See also p 305.

In this issue of THE JOURNAL, Bindman and colleagues¹ report that there is a relationship between better perceived access to health services overall and lower hospitalization rates for conditions preventable by adequate ambulatory care (ambulatory care—sensitive conditions, or ACSCs), thus confirming findings of earlier studies. In California alone, the literature on the value of access is rich: Roemer et al² demonstrated two decades ago that reductions in access led to higher hospitalization rates, and more recently the Rand Health Insurance Experiment and related studies³ also demonstrated adverse effects on outcome with reductions in access. Although there are other determinants of . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Health Policy and Management, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Md.

Footnotes
Reprint requests to Department of Health Policy and Management, The Johns Hopkins School of Hygiene and Public Health, 624 N Broadway, Baltimore, MD 21205 (Dr Starfield).

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