Washington Donna L, Villa Valentine, Brown Arleen, Damron-Rodriguez JoAnn, Harada Nancy
Department of Medicine, VA Greater Los Angeles Healthcare System, CA 90073, USA.
Am J Public Health. 2005 Dec;95(12):2231-7. doi: 10.2105/AJPH.2004.043570. Epub 2005 Oct 27.
We assessed racial/ethnic variations in patterns of ambulatory care use among Department of Veterans Affairs (VA) health care-eligible veterans to determine if racial/ethnic differences in health care use persist in equal-access systems.
We surveyed 3227 male veterans about their health and ambulatory care use.
Thirty-eight percent of respondents had not had a health care visit in the previous 12 months. Black (odds ratio [OR] = 0.5), Hispanic (OR = 0.4), and Asian/Pacific Islander veterans (OR=0.4) were less likely than White veterans to report any ambulatory care use. Alternately, Whites (OR=2.2) were more likely than other groups to report ambulatory care use. Being White was a greater predictor of health care use than was having fair or poor health (OR=1.4) or functional limitations (OR=1.5). In non-VA settings, racial/ethnic minorities were less likely to have a usual provider of health care. There was no VA racial/ethnic variation in this parameter.
Racial/ethnic disparities in health and health care use are present among VA health care-eligible veterans. Although the VA plays an important role in health care delivery to ethnic minority veterans, barriers to VA ambulatory care use and additional facilitators for reducing unmet need still need to be investigated.
我们评估了退伍军人事务部(VA)符合医疗条件的退伍军人在门诊医疗使用模式上的种族/民族差异,以确定在平等获取医疗系统中,医疗使用方面的种族/民族差异是否仍然存在。
我们对3227名男性退伍军人进行了关于他们的健康状况和门诊医疗使用情况的调查。
38%的受访者在过去12个月中没有进行过医疗就诊。黑人(优势比[OR]=0.5)、西班牙裔(OR=0.4)和亚太岛民退伍军人(OR=0.4)报告使用任何门诊医疗服务的可能性低于白人退伍军人。相反,白人(OR=2.2)报告使用门诊医疗服务的可能性高于其他群体。与健康状况一般或较差(OR=1.4)或有功能限制(OR=1.5)相比,白人是医疗服务使用的更强预测因素。在非VA医疗机构中,少数种族/民族拥有常规医疗服务提供者的可能性较小。在这一参数上,VA不存在种族/民族差异。
在符合VA医疗条件的退伍军人中,存在健康状况和医疗服务使用方面的种族/民族差异。尽管VA在为少数族裔退伍军人提供医疗服务方面发挥着重要作用,但VA门诊医疗使用的障碍以及减少未满足需求的其他促进因素仍需进行调查。