Dobbertin Konrad, Horner-Johnson Willi, Lee Jae Chul, Andresen Elena M
Institute on Development & Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239, USA.
Institute on Development & Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239, USA.
Disabil Health J. 2015 Apr;8(2):296-302. doi: 10.1016/j.dhjo.2014.08.012. Epub 2014 Aug 29.
Having a usual source of health care is positively associated with regular health maintenance visits and receipt of preventive services. People with disabilities are, overall, more likely than those without disabilities to have a usual source of care (USC). However, the population of people with disabilities is quite heterogenous, and some segments of the population may have less access to a USC than others.
To determine whether there are significant subgroup differences in having a USC within the U.S. population of working-age adults with disabilities, and to compare adults with and without disabilities while controlling for other subgroup differences.
We analyzed Medical Expenditure Panel Survey annual data files from 2002 to 2008. We performed both bivariate and multivariate logistic regression analyses to examine the relationship of sociodemographic and disability subgroup variables with having a USC.
Within the disability population, individuals who were younger; male; Black, Hispanic, or other (non-White) race; less educated; of lower income; or uninsured for part or all of the year were significantly less likely to have a USC. These differences mirrored those among adults without disabilities. When controlling for these differences, people with physical, hearing, or multiple disabilities had greater odds of having a USC than people without disabilities, but those with vision or cognitive limitations did not differ significantly from the non-disabled referent group.
Disparities among people with and without disabilities are similar, underscoring the need for attention to disparities within the disability population.
拥有常规的医疗保健来源与定期进行健康维护检查以及接受预防服务呈正相关。总体而言,残疾人比非残疾人更有可能拥有常规的医疗保健来源(USC)。然而,残疾人群体非常多样化,其中一些人群获得常规医疗保健来源的机会可能比其他人少。
确定在美国适龄工作残疾成年人中,在拥有常规医疗保健来源方面是否存在显著的亚组差异,并在控制其他亚组差异的同时,比较残疾人和非残疾人。
我们分析了2002年至2008年的医疗支出小组调查年度数据文件。我们进行了双变量和多变量逻辑回归分析,以检验社会人口统计学和残疾亚组变量与拥有常规医疗保健来源之间的关系。
在残疾人群体中,年龄较小、男性、黑人、西班牙裔或其他(非白人)种族、受教育程度较低、收入较低或一年中部分或全部时间未参保的个体拥有常规医疗保健来源的可能性显著较低。这些差异与非残疾成年人中的差异相似。在控制这些差异后,患有身体、听力或多重残疾的人比非残疾人拥有常规医疗保健来源的几率更高,但患有视力或认知障碍的人与非残疾参照组没有显著差异。
残疾人和非残疾人之间的差异相似,这突出了关注残疾人群体内差异的必要性。