Al Rifai Mahmoud, Kianoush Sina, Jain Vardhmaan, Minhas Abdul Mannan Khan, Hussain Aliza, Krittanawong Chayakrit, Patel Jaideep, Agarwala Anandita, Hanif Bashir, Samad Zainab, Yang Eugene, Virani Salim S
Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, TX.
Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH.
Kans J Med. 2022 Sep 21;15(3):352-357. doi: 10.17161/kjm.vol15.17942. eCollection 2022.
Some groups of Asian Americans, especially Asian Indians, experience higher rates of atherosclerotic cardiovascular disease (ASCVD) compared with other groups in the U.S. Barriers in accessing medical care partly may explain this higher risk as a result of delayed screening for cardiovascular risk factors and timely initiation of preventive treatment.
Cross-sectional data were utilized from the 2006 to 2015 National Health Interview Survey (NHIS). Barriers to accessing medical care included no place to seek medical care when needed, no healthcare coverage, no care due to cost, delayed care due to cost, inability to afford medication, or not seeing a doctor in the past 12 months.
The study sample consisted of 18,150 Asian individuals, of whom 20.5% were Asian Indian, 20.5% were Chinese, 23.4% were Filipino, and 35.6% were classified as "Other Asians". The mean (standard error) age was 43.8 (0.21) years and 53% were women. Among participants with history of hypertension, diabetes mellitus, or ASCVD (prevalence = 25%), Asian Indians were more likely to report delayed care due to cost (2.58 (1.14,5.85)), while Other Asians were more likely to report no care due to cost (2.43 (1.09,5.44)) or delayed care due to cost (2.35 (1.14,4.86)), compared with Chinese. Results among Filipinos were not statistically significant.
Among Asians living in the U.S. with cardiovascular risk factors or ASCVD, Asian Indians and Other Asians are more likely to report delayed care or no care due to cost compared with Chinese.
与美国其他群体相比,一些亚裔美国人,尤其是印度裔亚洲人,患动脉粥样硬化性心血管疾病(ASCVD)的比例更高。获得医疗保健方面的障碍可能部分解释了这种较高的风险,这是由于心血管危险因素筛查延迟和预防性治疗的及时启动所致。
利用2006年至2015年美国国家健康访谈调查(NHIS)的横断面数据。获得医疗保健的障碍包括在需要时无处求医、没有医疗保险、因费用而得不到治疗、因费用而延迟治疗、无力支付药物费用或在过去12个月内未看过医生。
研究样本包括18150名亚洲人,其中20.5%为印度裔亚洲人,20.5%为华裔,23.4%为菲律宾裔,35.6%被归类为“其他亚洲人”。平均(标准误差)年龄为43.8(0.21)岁,53%为女性。在有高血压、糖尿病或ASCVD病史的参与者中(患病率=25%),印度裔亚洲人更有可能报告因费用而延迟治疗(2.58(1.14,5.85)),而其他亚洲人比华裔更有可能报告因费用而得不到治疗(2.43(1.09,5.44))或因费用而延迟治疗(2.35(1.14,4.86))。菲律宾人的结果无统计学意义。
在美国患有心血管危险因素或ASCVD的亚洲人中,与华裔相比,印度裔亚洲人和其他亚洲人更有可能报告因费用而延迟治疗或得不到治疗。