King Christopher J, Chen Jie, Dagher Rada K, Holt Cheryl L, Thomas Stephen B
University of Maryland, College Park, MD
University of Maryland, College Park, MD.
Am J Med Qual. 2015 Sep-Oct;30(5):459-69. doi: 10.1177/1062860614537676. Epub 2014 Jun 5.
More research is needed to identify factors that explain why minority cancer survivors ages 18 to 64 are more likely to delay or forgo care when compared with whites. Data were merged from the 2000-2011 National Health Interview Survey to identify 12 125 adult survivors who delayed medical care. The Fairlie decomposition technique was applied to explore contributing factors that explain the differences. Compared with whites, Hispanics were more likely to delay care because of organizational barriers (odds ratio = 1.38; P < .05), and African Americans were more likely to delay medical care or treatment because of transportation barriers (odds ratio = 1.54; P < .001). The predicted probability of not receiving timely care because of each barrier was lowest among minorities. Age, insurance, perceived health, comorbidity, nativity, and year were significant factors that contributed to the disparities. Although expanded insurance coverage through the Affordable Care Act is expected to increase access, organizational factors and transportation play a major role.
需要开展更多研究，以确定能够解释18至64岁的少数族裔癌症幸存者为何比白人更有可能推迟或放弃治疗的因素。合并了2000 - 2011年全国健康访谈调查的数据，以确定12125名推迟医疗护理的成年幸存者。应用费尔利分解技术来探究导致差异的影响因素。与白人相比，西班牙裔更有可能因组织障碍而推迟治疗（优势比=1.38；P<.05），非裔美国人更有可能因交通障碍而推迟医疗护理或治疗（优势比=1.54；P<.001）。因每种障碍而未及时接受治疗的预测概率在少数族裔中最低。年龄、保险、自我感知健康状况、合并症、出生地和年份是导致差异的重要因素。尽管通过《平价医疗法案》扩大保险覆盖范围预计会增加医疗服务可及性，但组织因素和交通因素起着主要作用。
