Vargas Bustamante Arturo, Fang Hai, Rizzo John A, Ortega Alexander N
University of California, Los Angeles, CA, USA.
Med Care Res Rev. 2009 Oct;66(5):561-77. doi: 10.1177/1077558709338487. Epub 2009 Jun 25.
This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder-Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.
本研究假设,拉丁裔成年人(>18岁)在医疗保健可及性和利用率方面存在差异,具有墨西哥血统的美国拉丁裔成年人的可及性和利用率模式最差。分析使用了1999年至2007年的国家健康访谈调查(NHIS)数据(N = 33,908)。作者首先估计了不同类别的拉丁裔在医疗保健可及性和利用率方面的差异。他们还采用布林德-奥克萨卡方法将差异分解为可观察和不可观察的成分,将具有墨西哥血统的拉丁裔与非墨西哥拉丁裔进行比较。具有墨西哥血统的拉丁裔在医疗保健可及性和利用率模式上始终低于非墨西哥拉丁裔。医疗保险和居住地区是解释可观察到的差异的最重要因素。相比之下,语言和公民身份相对不太重要。虽然这些差异中有很大一部分可能可以由观察到的特征来解释,但不同拉丁裔群体之间因不可观察的异质性而产生的差异也相当大。