Leclere F B, Jensen L, Biddlecom A E
Population Research Institute, Pennsylvania State University.
J Health Soc Behav. 1994 Dec;35(4):370-84.
We use the 1990 National Health Interview Survey supplement on Family Resources to examine the health care utilization patterns of immigrant and native-born adults in the United States. We modify a standard health care utilization framework by including duration of residence in the United States and measures of immigrant adaptation and family health context to model both the probability and number of physician contacts in the previous year. We find that duration of residence has a strong effect. Recently-arrived immigrants are much less likely to have had a contact in the previous year and had fewer contacts than either native-born or longer-term immigrant adults. Once the measures of adaptation--age at immigration and language of survey interview--are included, immigrants who have been in the United States for 10 years or more are not statistically different from the native-born. Family characteristics, including measures of exposure to the formal health care system, slightly reduce the size of the effects but do not alter the basic relationship between duration of residence and health care utilization. These results suggest that, net of socioeconomic characteristics, access to health insurance, and differences in morbidity, recent immigrants are much less likely than both the native-born and those immigrants of longer duration, to receive timely health care.
我们利用1990年全国健康访谈调查中关于家庭资源的补充内容，来研究美国移民和本土出生成年人的医疗保健利用模式。我们对一个标准的医疗保健利用框架进行了修改，纳入了在美国的居住时长、移民适应措施以及家庭健康背景，以模拟上一年度与医生接触的概率和次数。我们发现居住时长有很大影响。最近抵达的移民在上一年度与医生接触的可能性要小得多，且接触次数比本土出生或长期移民的成年人都少。一旦纳入适应措施——移民时的年龄和调查访谈语言——在美国居住10年或更长时间的移民与本土出生的人在统计上没有差异。家庭特征，包括接触正规医疗保健系统的指标，会略微减小这种影响的幅度，但不会改变居住时长与医疗保健利用之间的基本关系。这些结果表明，在扣除社会经济特征、获得医疗保险的情况以及发病率差异之后，近期移民比本土出生的人和长期移民获得及时医疗保健的可能性要小得多。
