Department of Social and Behavioral Health, School of Rural Public Health, McAllen Campus, Texas A&M Health Science Center, McAllen, Texas 78503, USA.
Popul Health Manag. 2012 Jun;15(3):149-56. doi: 10.1089/pop.2011.0044. Epub 2012 Feb 7.
Little is known about predictors of health care utilization for older Hispanics with chronic conditions. This study aimed to determine: (1) the level of health care access for older Hispanics with type 2 diabetes living in a US-Mexico border area; and (2) personal and health correlates to health care utilization (ie, physician visits, eye care, emergency room [ER] use). This was a cross-sectional study based on a community assessment conducted at a clinic, senior centers, and colonias. Colonias are impoverished neighborhoods with substandard living conditions along the US-Mexico border. Hispanics living in colonias are one of the most disadvantaged minority groups in the United States. The study sample consisted of 249 Hispanics age 60 years and older who have type 2 diabetes. Descriptive analyses, multiple linear regression, and generalized linear models were conducted. Older age (P = 0.02) and affordability of physician fees (P = 0.02) were significant correlates to more frequent physician visits. Factors significantly associated with eye care were being insured (P = 0.001) and reporting high cholesterol (P = 0.005). ER use was significantly associated with younger age (60-64 years old; P = 0.03) and suffering from hypertension (P = 0.02). Those who received diabetes education (P = 0.04) were less likely to use the ER. Identifying patterns of health care utilization services in aging underserved minorities who are disproportionately affected by diabetes may lead to culturally appropriate preventive practices and timely access to health care. Adequate health care access can decrease or delay the onset of diabetes complications in older Hispanics with type 2 diabetes who live along the US-Mexico border.
对于居住在美国-墨西哥边境地区的患有慢性疾病的老年西班牙裔人群，人们对其医疗保健利用的预测因素知之甚少。本研究旨在确定：(1) 居住在美国-墨西哥边境地区的患有 2 型糖尿病的老年西班牙裔人群的医疗保健可及性水平；以及 (2) 与医疗保健利用相关的个人和健康因素（即医生就诊、眼科保健、急诊室[ER]就诊）。这是一项基于在诊所、老年人中心和 colonias 进行的社区评估的横断面研究。colonias 是美国-墨西哥边境地区贫困的社区，生活条件低于标准。居住在 colonias 的西班牙裔人群是美国最弱势的少数族裔之一。研究样本包括 249 名年龄在 60 岁及以上且患有 2 型糖尿病的西班牙裔人群。进行了描述性分析、多元线性回归和广义线性模型分析。较年长的年龄（P = 0.02）和医生费用的负担能力（P = 0.02）是医生就诊频率较高的显著相关因素。与眼科保健显著相关的因素是有保险（P = 0.001）和报告高胆固醇（P = 0.005）。急诊室就诊与年龄较小（60-64 岁；P = 0.03）和患有高血压（P = 0.02）显著相关。接受糖尿病教育的人（P = 0.04）较少使用急诊室。确定服务利用模式可以使受糖尿病不成比例影响的服务不足的老年少数族裔获得适当的文化适宜的预防实践和及时的医疗保健。适当的医疗保健可及性可以减少或延迟居住在美国-墨西哥边境地区的患有 2 型糖尿病的老年西班牙裔人群糖尿病并发症的发生。
