Weinick Robin M, Jacobs Elizabeth A, Stone Lisa Cacari, Ortega Alexander N, Burstin Helen
Office of Performance Accountability, Resources, and Technology, Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA.
Med Care. 2004 Apr;42(4):313-20. doi: 10.1097/01.mlr.0000118705.27241.7c.
Hispanic Americans are often treated as a monolithic ethnic group with a single pattern of healthcare utilization. However, there could be considerable differences within this population. We examine the association between use of healthcare services and Hispanic Americans'country of ancestry or origin, language of interview, and length of time lived in the United States.
Our data come from the Medical Expenditure Panel Survey, a nationally representative survey of healthcare use and expenditures. Descriptive statistics and logistic regression results are presented.
Multivariate models show that Mexicans and Cubans are less likely, and Puerto Ricans more likely, to have any emergency department visits than non-Hispanic whites. Mexicans, Central American/Caribbeans, and South Americans are less likely to have any prescription medications. All Hispanics are less likely to have any ambulatory visits and prescription medications, whereas only those with a Spanish-language interview are less likely to have emergency department visits and inpatient admissions. More recent immigrants are less likely to have any ambulatory care or emergency department visits, whereas all Hispanics born outside the United States are less likely to have any prescription medications.
The Hispanic population is composed of many different groups with diverse health needs and different barriers to accessing care. Misconceptions of Hispanics as a monolithic population lacking within-group diversity could function as a barrier to efforts aimed at providing appropriate care to Hispanic persons and could be 1 factor contributing to inequalities in the availability, use, and quality of healthcare services in this population.
西班牙裔美国人常被视为一个单一的种族群体,有着单一的医疗保健利用模式。然而,该群体内部可能存在相当大的差异。我们研究了医疗保健服务的使用与西班牙裔美国人的祖籍国或来源国、访谈语言以及在美国居住的时间长度之间的关联。
我们的数据来自医疗支出小组调查,这是一项关于医疗保健使用和支出的全国代表性调查。呈现了描述性统计数据和逻辑回归结果。
多变量模型显示,与非西班牙裔白人相比,墨西哥人和古巴人去急诊科就诊的可能性较小,而波多黎各人去急诊科就诊的可能性较大。墨西哥人、中美洲/加勒比地区人和南美洲人使用处方药的可能性较小。所有西班牙裔美国人进行门诊就诊和使用处方药的可能性较小,而只有那些接受西班牙语访谈的人去急诊科就诊和住院的可能性较小。新移民进行门诊护理或去急诊科就诊的可能性较小,而所有在美国境外出生的西班牙裔美国人使用处方药的可能性较小。
西班牙裔人口由许多不同的群体组成,他们有不同的健康需求和不同的就医障碍。将西班牙裔视为缺乏群体内部多样性的单一群体的误解可能会成为为西班牙裔提供适当护理的努力的障碍,并且可能是导致该群体在医疗保健服务的可及性、使用和质量方面存在不平等的一个因素。