Access to Health Care and Preventable Hospitalizations

Abstract

To Editor. —In article by Dr Bindman and colleagues 1 it was unsettling to see authors state that [a]ccess to care was inversely associated with hospitalization rates for five chronic conditions. This is not because their data are incompatible with many of our experiences, but because they echo landmark article by Hart 2 published 24 years ago in which he first used term inverse care law. Hart showed, via analyses of burdens of illness in regions of Great Britain with variations of social class and variations of physician quality, that the availability of good medical care tends to vary inversely with need for it in population served. At time, Hart's law stirred many in National Health Service to address inequities in quality and access for working class and poor in both urban and rural areas of