Borders Tyrone F, Brannon-Goedeke Angelique, Arif Ahmed, Xu Ke Tom
Division of Health Services Research, Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Med Care. 2004 Sep;42(9):884-92. doi: 10.1097/01.mlr.0000135818.47100.8c.
We investigated whether there were Mexican-American versus non-Hispanic white disparities in parents' reports of problems with 4 dimensions of children's medical care access after controlling for a range of demographic, social, economic, and health status factors.
Data were collected through a telephone survey of 5941 parents residing in Texas. The survey questionnaire included measures of the parent's demographic and socioeconomic status and the child's health-related quality of life. The behavioral model was used to guide the inclusion of factors in multivariate logistic regression analyses of parents' reports of their children's ability to obtain an appointment for routine/regular care, obtain care for illness/injury, obtain help/advice over the phone when calling the doctor's office, and having to wait more than 15 minutes in the doctor's office.
Mexican-American parents had worse reports of all 4 dimensions of their children's access even after controlling for predisposing, enabling, and need factors. Among Mexican-Americans, there were no differences between those who primarily spoke English versus Spanish. Other factors that were significantly associated with at least 2 reports of access were household income, the child's insurance status, and the child's health-related quality of life.
Mexican-American children face problems accessing medical care in a timely manner that are not fully explained by parents' demographic, social, and economic status or children's health-related quality of life. Health policy makers, managers, and clinicians should further consider how they could reduce the inequity of access to medical services among Mexican-American children.
在控制一系列人口统计学、社会、经济和健康状况因素后,我们调查了墨西哥裔美国人与非西班牙裔白人在父母报告的儿童医疗保健获取四个维度问题上是否存在差异。
通过对居住在德克萨斯州的5941名父母进行电话调查收集数据。调查问卷包括父母的人口统计学和社会经济状况以及儿童与健康相关的生活质量的测量指标。行为模型用于指导在多变量逻辑回归分析中纳入因素,该分析涉及父母报告其子女获得常规/定期护理预约、获得疾病/受伤护理、致电医生办公室时通过电话获得帮助/建议以及在医生办公室等待超过15分钟的能力。
即使在控制了易患因素、促成因素和需求因素后,墨西哥裔美国父母在其子女获取医疗保健的所有四个维度上的报告情况更差。在墨西哥裔美国人中,主要说英语和说西班牙语的人之间没有差异。与至少两项获取医疗保健报告显著相关的其他因素包括家庭收入、儿童的保险状况以及儿童与健康相关的生活质量。
墨西哥裔美国儿童在及时获得医疗保健方面面临问题,而父母的人口统计学、社会和经济状况或儿童与健康相关的生活质量并不能完全解释这些问题。卫生政策制定者、管理人员和临床医生应进一步考虑如何减少墨西哥裔美国儿童在获得医疗服务方面的不平等。