Reema Dedania is with the Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN. Gilbert Gonzales is with the Department of Health Policy, Vanderbilt University School of Medicine, Nashville.
Am J Public Health. 2019 Jun;109(S3):S221-S227. doi: 10.2105/AJPH.2019.305149.
To compare access to care between US-born and foreign-born US adults by mental health status. We analyzed data on nonelderly adults (n = 100 428) from the 2013-2016 National Health Interview Survey. We used prevalence estimates and multivariable logistic regression models to compare issues of affordability and accessibility between US-born and foreign-born individuals. Approximately 22.2% of US-born adults and 18.1% of foreign-born adults had symptoms of moderate to severe psychological distress. Compared with US-born adults with no psychological distress, and after adjustment for sociodemographic characteristics, US-born and foreign-born adults with psychological distress were much more likely to report multiple emergency room visits and unmet medical care, mental health care, and prescription medications because of cost. Our study found that adults with moderate to severe psychological distress, regardless of their immigration status, were at greater risk for reporting issues of affordability when accessing health care compared with US-born adults with no psychological distress. Health care and mental health reforms should focus on reducing health care costs and establishing innovative efforts to broaden access to care to diverse populations.
比较心理健康状况不同的美国本土出生和外国出生的美国成年人的医疗服务可及性。我们分析了 2013-2016 年全国健康访谈调查中关于非老年成年人（n=100428）的数据。我们使用患病率估计值和多变量逻辑回归模型比较了美国本土出生者和外国出生者之间的负担能力和可及性问题。约 22.2%的美国本土出生的成年人和 18.1%的外国出生的成年人有中度至重度心理困扰的症状。与没有心理困扰的美国本土出生的成年人相比，调整了社会人口统计学特征后，有心理困扰的美国本土出生者和外国出生者更有可能因费用过高而多次急诊就诊和无法获得医疗、精神保健和处方药物。我们的研究发现，无论移民身份如何，有中度至重度心理困扰的成年人在获得医疗保健方面报告负担能力问题的风险更高，而没有心理困扰的美国本土出生的成年人。医疗保健和精神卫生改革应侧重于降低医疗保健成本，并制定创新努力，扩大对不同人群的医疗服务。
