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美国参保儿童进行门诊就医、看牙医、住院治疗及使用处方药的相关因素:健康服务利用行为模型的应用

Factors Associated with Insured Children's Use of Physician Visits, Dentist Visits, Hospital Care, and Prescribed Medications in the United States: An Application of Behavioral Model of Health-Services Use.

作者信息

Cheng Tyrone C, Lo Celia C

机构信息

Little Hall, School of Social Work, University of Alabama, Tuscaloosa, AL 35401, USA.

Defense Personnel and Security Research Center, Peraton, Seaside, CA 93955, USA.

出版信息

Int J Environ Res Public Health. 2024 Mar 31;21(4):427. doi: 10.3390/ijerph21040427.

Abstract

This study is the first to examine factors in the utilization of physician services, dentist services, hospital care, and prescribed medications focusing exclusively on insured children in the United States. Data describing 48,660 insured children were extracted from the 2021 National Survey of Children's Health. Children in the present sample were covered by private health insurance, public health insurance, or other health insurance. Logistic regression results showed self-reported health to be negatively associated with physician visits, hospital-care use, and prescription use, but teeth condition to be positively associated with dentist visits. Physician visits were associated negatively with age, Hispanic ethnicity, Asian ethnicity, family income at or below 200% of the federal poverty level, and other health insurance, but positively with parental education and metropolitan residency. Dentist visits were associated positively with girls, age, and parental education, but negatively with Asian ethnicity and public health insurance. Use of hospital care was associated negatively with age and Asian ethnicity, but positively with parental education and public health insurance. Use of prescriptions was associated positively with age, Black ethnicity, parental education, and public health insurance, but negatively with Hispanic ethnicity, Asian ethnicity, and family income at or below 200% of the federal poverty level. Implications included the expansion of public health insurance, promotion of awareness of medicine discount programs, and understanding of racial/ethnic minorities' cultural beliefs in health and treatment.

摘要

本研究首次专门针对美国有保险的儿童,考察了其在使用医生服务、牙医服务、住院护理和处方药方面的影响因素。描述48,660名有保险儿童的数据摘自2021年全国儿童健康调查。本样本中的儿童享有私人医疗保险、公共医疗保险或其他医疗保险。逻辑回归结果显示,自我报告的健康状况与看医生、住院护理使用和处方使用呈负相关,但牙齿状况与看牙医呈正相关。看医生与年龄、西班牙裔、亚裔、家庭收入处于或低于联邦贫困线的200%以及其他医疗保险呈负相关,但与父母教育程度和大城市居住情况呈正相关。看牙医与女孩、年龄和父母教育程度呈正相关,但与亚裔和公共医疗保险呈负相关。住院护理的使用与年龄和亚裔呈负相关,但与父母教育程度和公共医疗保险呈正相关。处方的使用与年龄、黑人种族、父母教育程度和公共医疗保险呈正相关,但与西班牙裔、亚裔以及家庭收入处于或低于联邦贫困线的200%呈负相关。研究启示包括扩大公共医疗保险、提高对药品折扣计划的认识,以及了解少数种族在健康和治疗方面的文化信仰。

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