Lurie Institutte for Disability Policy, Heller School for Social Policy and Management, Brandies University, Waltham, MA 02454, USA.
Am J Intellect Dev Disabil. 2012 Jul;117(4):304-15. doi: 10.1352/1944-7558-117.4.304.
This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N = 4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with autism and other developmental disabilities had a consistent pattern of worse health care access, utilization, and quality. We then test mediation models to determine if health care quality mediates the relationship between ethnicity and health care utilization disparities. Three of four quality indicators (provider does not spend enough time with child, provider is not culturally sensitive, and provider does not make parent feel like a partner) were significant mediators. These analyses suggest that interventions targeted at improving providers' cultural sensitivity and behavior during the clinical encounter may reduce disparities in the health care utilization of Latino children with autism and other developmental disabilities.
本研究考察了拉丁裔自闭症和其他发育障碍儿童的医疗保健可及性、利用情况和质量。我们分析了来自有特殊健康需求儿童国家调查的数据(N=4414 名自闭症和其他发育障碍儿童)。与白人儿童相比,患有自闭症和其他发育障碍的拉丁裔儿童在医疗保健的可及性、利用率和质量方面存在着一贯的劣势。然后,我们测试了中介模型,以确定医疗保健质量是否在族裔和医疗保健利用差异之间起中介作用。四个质量指标中有三个(提供者没有花足够的时间与孩子在一起、提供者没有文化敏感性、提供者没有让家长感到是合作伙伴)是显著的中介变量。这些分析表明,针对改善提供者在临床接触期间的文化敏感性和行为的干预措施,可能会减少自闭症和其他发育障碍的拉丁裔儿童在医疗保健利用方面的差异。