Type of health insurance and the quality of primary care experience

Objectives. This study examined the association between type of health insu rance coverage and quality of primary care as measured by its distinguishin g attributes-first contact, longitudinality, comprehensiveness. and coordin ation. Methods. The household component of the 1996 Medical Expenditure Panel Surv ey was used for this study. The analysis primarily focused on subjects aged younger than 65 years who identified a usual source of care. Logistic regr essions were used to examine the independent effects of insurance status on primary care attributes while individual sociodemographic characteristics were controlled for. Results. The experience of primary care varies according to insurance statu s. The insured are able to obtain better primary care than the uninsured, a nd the privately insured are able to obtain better primary care than the pu blicly insured. Those insured through fee-for-service coverage experience b etter longitudinal care and less of a barrier to access than those insured through health maintenance organizations (HMOs). Conclusions. While expanding insurance coverage is important for establishi ng access to care, efforts are needed to enhance the quality of primary hea lth care, particularly for the publicly insured. Policymakers should closel y monitor the quality of primary care provided by HMOs.