Cornelius L J
US Department of Health and Human Services, Agency for Health Care Policy and Research, Rockville, MD 20857.
J Natl Med Assoc. 1991 Jul;83(7):617-26.
Blacks have been directly or indirectly affected by changes in policies such as cutbacks in the Medicaid program or decreases in the funding of graduate medical education. Yet there is considerable disagreement over whether blacks have achieved equity of access to medical care. Descriptive and multivariate regression analyses were conducted to examine the use of ambulatory and inpatient medical care by 1150 whites and blacks under the age of 65 who experienced an episode of illness and lived around sites serviced by the Community Hospital Program, which was developed to increase primary care in underserved communities. After controlling for demographic factors, health status, and aspects of the usual source of care, multivariate analyses revealed that race was not a determinant of differences found in the use of ambulatory and inpatient medical care or the likelihood that an individual was cured of the condition causing him or her the most worry. Differences in the use of care for blacks were believed to have occurred because blacks were disproportionately found in groups that used less medical care, ie, low-income groups, the uninsured, and those without a usual source of care.
黑人受到了诸如医疗补助计划削减或研究生医学教育资金减少等政策变化的直接或间接影响。然而，对于黑人是否已实现获得医疗保健的公平性，存在相当大的分歧。进行了描述性和多变量回归分析，以研究1150名65岁以下的白人和黑人对门诊和住院医疗服务的使用情况，这些人经历过疾病发作，居住在社区医院项目所服务的地点附近，该项目旨在增加服务不足社区的初级保健。在控制了人口因素、健康状况和常规医疗服务来源的各个方面后，多变量分析显示，种族并非门诊和住院医疗服务使用差异或个人治愈引起其最大担忧疾病可能性的决定因素。黑人在医疗服务使用上的差异被认为是因为在使用较少医疗服务的群体中，即低收入群体、未参保者和没有常规医疗服务来源的群体中，黑人的比例过高。
