Shi Leiyu, Lebrun Lydie A, Tsai Jenna
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
South Med J. 2010 Jun;103(6):509-16. doi: 10.1097/SMJ.0b013e3181d9c2d8.
After accounting for socioeconomic factors and other demographic characteristics, racial/ethnic disparities in access to care were examined.
Using nationally representative data on 34,403 individuals from the 2004 Medical Expenditure Panel Survey (MEPS), multiple logistic regression analyses for five outcome measures were conducted: self-reports of being unable to get medical care, dental care, or prescriptions in the past year; and having no doctor or dentist visits in the past year. The main independent variables were race/ethnicity, income, and insurance status.
Blacks and Hispanics were less likely to report difficulties in accessing medical care, dental care, and prescriptions as compared to whites. These disparities occurred primarily among the uninsured and Medicaid insured. More objective measures of utilization (ie, no doctor visit or dental visit during the past year) showed that minorities experienced less access than whites.
Racial/ethnic disparities in access to care persist, and cannot be entirely explained by socioeconomic differences. In addition, the nature of these disparities depends on the socioeconomic position of racial/ethnic groups as well as the access measure used.
在考虑社会经济因素和其他人口特征后,对获得医疗服务方面的种族/族裔差异进行了研究。
利用2004年医疗支出小组调查(MEPS)中34403名个体的全国代表性数据,对五项结果指标进行了多项逻辑回归分析:过去一年中无法获得医疗服务、牙科护理或处方的自我报告;以及过去一年中未看过医生或牙医。主要自变量为种族/族裔、收入和保险状况。
与白人相比,黑人和西班牙裔报告在获得医疗服务、牙科护理和处方方面存在困难的可能性较小。这些差异主要发生在未参保者和医疗补助参保者中。更客观的利用指标(即过去一年中未看过医生或牙医)显示,少数族裔获得医疗服务的机会比白人少。
获得医疗服务方面的种族/族裔差异依然存在,且不能完全由社会经济差异来解释。此外,这些差异的性质取决于种族/族裔群体的社会经济地位以及所使用的获得医疗服务指标。