Ortega Alexander N, Fang Hai, Perez Victor H, Rizzo John A, Carter-Pokras Olivia, Wallace Steven P, Gelberg Lillian
Department of Health Services, School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095-1772, USA.
Arch Intern Med. 2007 Nov 26;167(21):2354-60. doi: 10.1001/archinte.167.21.2354.
We compared access to health care, use of services, and health care experiences for Mexicans and other Latinos by citizenship and immigrant authorization status.
We acquired data from the 2003 California Health Interview Survey, with 42,044 participants representative of noninstitutionalized households. Participants were differentiated by ethnicity/race, national origin, and citizenship/immigration authorization status. Outcome measures included having a usual source of care, problems in obtaining necessary care, use of physician and emergency department care, and 3 experiences with health care. Multivariate analyses measured the associations of citizenship/immigration authorization status with the outcome measures among foreign-born Mexicans and other Latinos vs their US-born counterparts.
In multivariate analyses, undocumented Mexicans had 1.6 fewer physician visits (P < .01); compared with US-born Mexicans; other undocumented Latinos had 2.1 fewer visits (P < .01) compared with their US-born counterparts. Both undocumented groups were less likely to report difficulty obtaining necessary health care than US-born Mexicans (odds ratio, 0.68; P < .01) and other US-born Latinos (odds ratio, 0.40; P < .01), respectively. Undocumented Mexicans were less likely to have a usual source of care (odds ratio, 0.70; P < .01) and were more likely to report negative experiences than US-born Mexicans (odds ratio, 1.93; P < .01). Findings were similar for other undocumented Latinos, with the exception of having a usual source of care. Patterns of access to and use of health care services tended to improve with changing legal status.
In this large sample, undocumented Mexicans and other undocumented Latinos reported less use of health care services and poorer experiences with care compared with their US-born counterparts, after adjustment for confounders in multivariate analyses.
我们根据公民身份和移民授权状态，比较了墨西哥人和其他拉丁裔美国人获得医疗保健服务的机会、服务使用情况以及医疗保健体验。
我们从2003年加利福尼亚健康访谈调查中获取数据，该调查有42044名参与者，代表非机构化家庭。参与者按种族/族裔、国籍和公民身份/移民授权状态进行区分。结果指标包括有常规医疗服务来源、获取必要医疗服务时遇到的问题、医生诊疗和急诊科服务的使用情况，以及3种医疗保健体验。多变量分析测量了外国出生的墨西哥人和其他拉丁裔美国人与其在美国出生的同龄人相比，公民身份/移民授权状态与结果指标之间的关联。
在多变量分析中，无证墨西哥人就诊次数比在美国出生的墨西哥人少1.6次（P <.01）；与在美国出生的其他拉丁裔相比，其他无证拉丁裔就诊次数少2.1次（P <.01）。两个无证群体报告难以获得必要医疗保健服务的可能性均低于在美国出生的墨西哥人（优势比，0.68；P <.01）和在美国出生的其他拉丁裔（优势比，0.40；P <.01）。无证墨西哥人有常规医疗服务来源的可能性较小（优势比，0.70；P <.01），且比在美国出生的墨西哥人更有可能报告负面体验（优势比，1.93；P <.01）。其他无证拉丁裔的情况类似，但在有常规医疗服务来源方面除外。随着法律身份的变化，获得和使用医疗保健服务的模式往往会有所改善。
在这个大样本中，在多变量分析中对混杂因素进行调整后，无证墨西哥人和其他无证拉丁裔报告的医疗保健服务使用较少，且护理体验比在美国出生的同龄人更差。
