Termination of medi-cal benefits. A follow-up study one year later
In a first study, the subjects perceptions of their access to care and their satisfaction with the care they received had fallen markedly at six months. Concomitant changes were seen in their health: General health status fell by 8 points on a 100-point scale, and the average increase in diastolic blood pressure among persons with hypertension was 10 mm Hg. These changes were not seen in a comparison group of 109 patients from the same practice whose Medi-Cal benefits were not terminated. One possible explanation for those findings was that they reflected a temporaty phenomenon and that the reductions in access, satisfaction, and health status would disappear after an initial period of disruption had passed. To test this hypothesis and to examine the influence of loss of insurance on the study findings, we reevaluated all the medically indigent adults and patients in the comparison group from the earlier study after one year.