The fundamental questions this study raised are whether variations in access to service delivery systems persist among Medicaid beneficiaries, and whether they contribute to inequitable medical care utilization. Theoretically, from a structural perspective, examining factors relevant to access to health care, this research attempts to demonstrate that equity in access to care can only be built on equity in access to service delivery systems and, moreover, to socioeconomic resources at the community level. / The study population is Persons With AIDS (PWAs) under the coverage of Florida Medicaid. Variations in their access to the home and community-based services (HCBS) program by gender and race, and its subsequent impact on medical care utilization are examined. / This study found that differentials in access to the HCBS program among the Medicaid recipients by gender, race, and socioeconomic conditions of PWAs' county of residence exist in Florida Medicaid; and gender, race, and the PAC program participation are significant factors influencing utilization of inpatient hospital and intensity of physician care for certain HIV/AIDS-related infections. It is the conclusion of this study that inequity in medical care stems from inequity in access to service delivery systems. A defacto separate health care system for women, blacks, or poor communities is very likely to result in unequal health care for these groups. / Theoretically this study highlights the complex relationship among gender, race, and health care in a society where economic means and health care facilities are unequally distributed. Universal coverage of health care services for all must be accompanied by changes in the organization of the health care delivery system and in the socioeconomic conditions of the low-income communities. Otherwise, the coverage will not only add more to the already spiraling health care cost, but also prove ineffective in providing health care to large segments of the most needy population. / Source: Dissertation Abstracts International, Volume: 55-08, Section: A, page: 2584. / Major Professor: Isaac W. Eberstein. / Thesis (Ph.D.)--The Florida State University, 1994.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_77204 |
| Contributors | Han, Lein Fang., Florida State University |
| Source Sets | Florida State University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | 165 p. |
| Rights | On campus use only. |
| Relation | Dissertation Abstracts International |
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