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Whom do we reach? A study of health care utlilzation.

Two groups of families, all eligible for a neighborhood pediatric program, were compared as to enrollment and utilization. It was hypothesized that, despite popular assumptions of homogeneity, the "urban poor" present a wide range of family characteristics, problems, and resource utilization patterns. Sample selection was based on 391 ranked "family functioning" scores derived from an earlier survey. The two study groups comprised the 27 highest need (HN) and the 27 lowest need (LN) families. Service records indicated that HN families completed fewer medical and dental registrations, basic examinations, appointments, and referrals. Moreover, the HN group featured significantly more fatherless homes, nuclear families, public welfare dependency, non-working mothers, residential mobility, and irregular school status. A matrix of several objective indicators is proposed for differentiating truly "high risk" families from other residents of "disadvantaged" neighborhoods. Recommendations cover special outreach and supportive services to families resembling the HN/low utilization profile.