Stewart T, May P, Muneta A
Med Care. 1980 Dec;18(12):1183-91. doi: 10.1097/00005650-198012000-00004.
The findings of a health consumer survey of 309 Navajo families in three areas of the Navajo Reservation are reported. The survey shows that access to facilities and lack of safe water and sanitary supplies are continuing problems for these families. The families show consistent use of Indian Health Service providers, particularly nurses, pharmacists and physicians, as well as traditional Navajo medicine practitioners. Only incidental utilization of private medical services is reported. Extended waiting times and translation from English to Navajo are major concerns in their contacts with providers. A surprisingly high availability of third-party insurance is noted. Comparisons are made between this data base and selected national and regional surveys, and with family surveys from other groups assumed to be disadvantaged in obtaining health care. The comparisons indicate somewhat lower utilization rates and more problems in access to care for this Navajo sample. The discussion suggests that attitudes regarding free health care eventually may be a factor for Navajo people and other groups, that cultural considerations are often ignored or accepted as truisms in delivering care, and that the Navajo Reservation may serve as a unique microcosm of health care in the U.S.
报告了对纳瓦霍保留地三个地区309个纳瓦霍家庭进行的健康消费者调查结果。调查显示,这些家庭在使用设施方面存在问题,并且缺乏安全饮用水和卫生用品。这些家庭持续使用印第安卫生服务机构的医疗服务人员,尤其是护士、药剂师和医生,以及传统的纳瓦霍医学从业者。据报告,他们只是偶尔使用私人医疗服务。在与医疗服务人员接触时,长时间等待以及英语到纳瓦霍语的翻译是他们主要关心的问题。值得注意的是,第三方保险的可获得性出奇地高。将该数据库与选定的全国性和地区性调查以及其他被认为在获得医疗保健方面处于不利地位的群体的家庭调查进行了比较。比较结果表明,这个纳瓦霍样本的利用率略低,在获得医疗服务方面存在更多问题。讨论表明,对于纳瓦霍人和其他群体来说,关于免费医疗保健的态度最终可能是一个因素,在提供医疗服务时,文化因素常常被忽视或被当作不言而喻的真理接受,并且纳瓦霍保留地可能是美国医疗保健的一个独特缩影。