Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Am J Public Health. 2013 Jul;103(7):1306-13. doi: 10.2105/AJPH.2012.301096. Epub 2013 May 16.
We examined racial/ethnic disparities in health care receipt among a nationally representative sample of male cancer survivors.
We identified men aged 18 years and older from the 2006-2010 National Health Interview Survey who reported a history of cancer. We assessed health care receipt in 4 self-reported measures: primary care visit, specialist visit, flu vaccination, and pneumococcal vaccination. We used hierarchical logistic regression modeling, stratified by age (< 65 years vs ≥ 65 years).
In adjusted models, older African American and Hispanic survivors were approximately twice as likely as were non-Hispanic Whites to not see a specialist (odds ratio [OR] = 1.78; 95% confidence interval [CI] = 1.19, 2.68 and OR = 2.09; 95% CI = 1.18, 3.70, respectively), not receive the flu vaccine (OR = 2.21; 95% CI = 1.45, 3.37 and OR = 2.20; 95% CI = 1.21, 4.01, respectively), and not receive the pneumococcal vaccine (OR = 2.24; 95% CI = 1.54, 3.24 and OR = 3.10; 95% CI = 1.75, 5.51, respectively).
Racial/ethnic disparities in health care receipt are evident among older, but not younger, cancer survivors, despite access to Medicare. These survivors may be less likely to see specialists, including oncologists, and receive basic preventive care.
我们考察了一个具有全国代表性的男性癌症幸存者样本中,卫生保健服务获得方面的种族/民族差异。
我们从 2006-2010 年全国健康访谈调查中确定了年龄在 18 岁及以上、报告有癌症病史的男性。我们使用 4 项自我报告的指标评估卫生保健服务的获得情况:初级保健就诊、专科就诊、流感疫苗接种和肺炎球菌疫苗接种。我们使用分层逻辑回归模型,按年龄(<65 岁与≥65 岁)进行分层。
在调整后的模型中,年龄较大的非裔美国人和西班牙裔幸存者与非西班牙裔白人相比,看专科医生的可能性较小(比值比[OR] = 1.78;95%置信区间[CI] = 1.19,2.68 和 OR = 2.09;95% CI = 1.18,3.70),不太可能接种流感疫苗(OR = 2.21;95% CI = 1.45,3.37 和 OR = 2.20;95% CI = 1.21,4.01),也不太可能接种肺炎球菌疫苗(OR = 2.24;95% CI = 1.54,3.24 和 OR = 3.10;95% CI = 1.75,5.51)。
尽管有医疗保险,在年龄较大的(但不是年龄较小的)癌症幸存者中,仍然存在卫生保健服务获得方面的种族/民族差异。这些幸存者看专科医生(包括肿瘤医生)和接受基本预防保健的可能性可能较低。