Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pa.
Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pa.
Acad Pediatr. 2018 Jan-Feb;18(1):20-25. doi: 10.1016/j.acap.2016.12.017. Epub 2017 Jan 5.
To assess differences in health care access, utilization, and experiences among Latino children in California according to parental citizenship status and language use.
Data are from the 2011 and 2012 California Health Interview Survey public use child files. A total of 2841 interviews of parents of Latino children younger than the age of 12 years were conducted. Analyses were conducted to determine the associations between access (usual of source of care, delay in receiving needed care, health insurance), utilization (physician visits in past year, emergency department visits), and experiences (doctor listens, doctor explains instructions clearly, communication via telephone or e-mail) according to parental citizenship status and household language use after adjusting for confounders.
In multivariate analyses, there were no significant differences in access to care according to parental citizenship status. Children with 2 noncitizen parents had fewer doctor visits and were less likely to go to the emergency department in the past year than those with 2 citizen parents. Among children with 1 or 2 noncitizen parents, their parents reported worse experiences in care than those with 2 citizen parents. Similar results were observed for language use. Parents of children in bilingual and Spanish-only households were less likely to report that their children's doctors explained things clearly, and parents in Spanish-only households were less likely to communicate via telephone or e-mail than those in English-only households.
Health policy should focus on provider-parent communication to ensure health care equity for Latino children whose parents are not citizens or do not speak English.
根据父母的公民身份和语言使用情况，评估加利福尼亚州拉丁裔儿童在获得医疗保健、利用医疗保健和就医体验方面的差异。
数据来自 2011 年和 2012 年加利福尼亚健康访谈调查公共使用儿童档案。对 2841 名 12 岁以下拉丁裔儿童父母进行了访谈。分析了根据父母的公民身份和家庭语言使用情况，在调整混杂因素后，与获得医疗服务（通常的医疗服务来源、接受所需医疗服务的延迟、医疗保险）、利用医疗服务（过去一年看医生的次数、去急诊室就诊的次数）和就医体验（医生倾听、医生清楚地解释说明、通过电话或电子邮件进行沟通）相关的关联。
在多变量分析中，根据父母的公民身份，在获得医疗服务方面没有显著差异。有 2 位非公民父母的儿童就诊次数较少，在过去一年中去急诊室就诊的可能性也低于有 2 位公民父母的儿童。在有 1 位或 2 位非公民父母的儿童中，其父母报告的就医体验比有 2 位公民父母的儿童差。对于语言使用情况也观察到了类似的结果。有 1 位或 2 位非公民父母的儿童的父母不太可能报告其子女的医生能清楚地解释问题，而西班牙语家庭的父母不太可能通过电话或电子邮件进行沟通，而英语家庭的父母则更有可能。
卫生政策应注重提供者与家长的沟通，以确保父母不是公民或不会说英语的拉丁裔儿童享有医疗保健公平。
