Dual Utilization of Medical Services by Low Income Latino Families: An Exploratory Investigation

Abstract

Dual utilization, client long-term use of two or more medical providers, was investigated in this exploratory study. This study examines financial, structural, and cultural factors associated with choice and patterns of dual utilization. Specifically, is there evidence that any one of these factors is strong enough to systematically influence dual use behavior? An in-depth interview was conducted of fifty low income Latino family members who used two providers: Kaiser HMO and La Clinica de La Raza. Latino families chose to use and pay for clinic services even though the same services could be obtained at almost no cost through their Kaiser HMO coverage. The majority of services puchased at the clinic related to pre/postnatal care and birth control for the women and to optometry and dentistry for the men. The research suggests that any expenditure for services which could have been obtained at no cost from Kaiser supports the importance of the contextual conditions associated with the purchased service. Although the HMO system has experienced significant growth, results of this research raise the question of their level of comprehensiveness.