Department of Economics, Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA.
Med Care. 2012 Apr;50(4):327-34. doi: 10.1097/MLR.0b013e318245a111.
To examine recent changes in racial and ethnic disparities in access to physician services in the United States, and investigate the economic factors driving the changes observed.
Using nationally representative data on adults aged 25-64 from the 2000 and 2007 Medical Expenditure Panel Survey, we examine changes in two measures of access: whether the individual reported having a usual source of care, and whether he/she had any doctor visits during the past year. In each year, we calculate disparities in access between African Americans and Whites, and between Hispanics and Whites, applying the Institute of Medicine's definition of a disparity. Nonlinear regression decomposition techniques are then used to quantify how changes in personal characteristics, comparing 2000 and 2007, helped shape the changes observed.
Large disparities in access to physician care were evident for both minority groups in 2000 and 2007. Disparities in no doctor visits during the past year diminished for African Americans, but disparities in both measures worsened sharply for Hispanics.
Disparities in access to physician care are improving for African Americans in one dimension, but eroding for Hispanics in multiple dimensions. The most important contributing factors to the growing disparities between Hispanics and Whites are health insurance, education, and income differences.
考察美国在获得医生服务方面的种族和民族差异的最新变化，并研究推动所观察到的变化的经济因素。
利用来自 2000 年和 2007 年医疗支出调查的 25-64 岁成年人的全国代表性数据，我们检查了两种获得途径的变化：个人是否报告有常规医疗服务来源，以及他/她在过去一年中是否有任何医生就诊。在每年，我们根据医学研究所的差异定义，计算非裔美国人和白人之间以及西班牙裔和白人之间在获得途径方面的差异。然后使用非线性回归分解技术来量化 2000 年和 2007 年个人特征的变化如何影响所观察到的变化。
在 2000 年和 2007 年，两个少数群体在获得医生护理方面都存在明显的差异。过去一年没有医生就诊的差异对于非裔美国人有所缩小，但对于西班牙裔人的两个衡量标准却急剧恶化。
在一个维度上，非裔美国人获得医生护理的差异正在改善，但在多个维度上，西班牙裔人的差异正在扩大。导致西班牙裔人和白人之间差距不断扩大的最重要因素是医疗保险、教育和收入差异。
