Moore P, Hepworth J T
Arizona State University College of Nursing, Tempe 85287-2602.
JAMA. 1994 Jul 27;272(4):297-304.
Lack of health insurance and a regular source of medical care are barriers affecting use of health services by Mexican Americans. We studied perinatal and infant health service use by Mexican-American women and non-Hispanic white women and their infants enrolled in Arizona's Medicaid program and explored characteristics associated with use of health services.
A descriptive comparative study that used data collected from office records, birth certificates, and household interviews.
Participants resided in the state's most populous county and were enrolled in the Arizona Health Care Cost Containment System, a health maintenance organization-oriented Medicaid demonstration project.
Random sample of 308 Mexican-American mother-infant dyads and 312 non-Hispanic white mother-infant dyads. The women were enrolled before the sixth month of pregnancy and for 60 days post partum; their infants were continuously enrolled throughout their first year.
Timing and number of prenatal visits and a modified Kessner Index, postpartum visits, number and purpose of office visits during the infants' first year, and immunizations received.
Mexican Americans averaged fewer prenatal visits than non-Hispanic whites (8.6 vs 10.2 visits) and were less likely to have "adequate" care (41.1% vs 52.8%). Both groups of mothers are well below the 68% of women nationally who receive adequate prenatal care. Controlling for important socioeconomic status and cultural characteristics, ethnicity had a strong independent effect on the number of prenatal visits and adequacy of prenatal care. Mexican-American infants made fewer visits (8.2 vs 9.8) and completed fewer age-appropriate immunizations than non-Hispanic whites.
Health insurance and a regular source of care are insufficient conditions for ensuring adequate use of maternal and child health services by Mexican-American Medicaid enrollees. Factors associated with their less frequent use of these preventive health services include higher numbers of children, transportation problems, and less assistance from their support system.
缺乏医疗保险和固定的医疗保健来源是影响墨西哥裔美国人使用医疗服务的障碍。我们研究了参加亚利桑那州医疗补助计划的墨西哥裔美国妇女及非西班牙裔白人妇女及其婴儿围产期和婴儿期医疗服务的使用情况，并探讨了与医疗服务使用相关的特征。
一项描述性比较研究，使用从办公室记录、出生证明和家庭访谈中收集的数据。
参与者居住在该州人口最多的县，并参加了亚利桑那医疗费用控制系统，这是一个以健康维护组织为导向的医疗补助示范项目。
308对墨西哥裔美国母婴二元组和312对非西班牙裔白人母婴二元组的随机样本。这些妇女在怀孕第六个月前登记，并在产后60天内登记；她们的婴儿在出生后的第一年持续登记。
产前检查的时间和次数以及改良的凯斯纳指数、产后检查、婴儿出生后第一年的门诊次数和目的，以及接种疫苗情况。
墨西哥裔美国人的产前检查平均次数少于非西班牙裔白人（8.6次对10.2次），并且获得“充分”护理的可能性较小（41.1%对52.8%）。两组母亲都远低于全国获得充分产前护理的68%的妇女比例。在控制了重要的社会经济地位和文化特征后，种族对产前检查次数和产前护理的充分性有很强的独立影响。墨西哥裔美国婴儿的就诊次数（8.2次对9.8次）少于非西班牙裔白人，并且完成的适龄疫苗接种也较少。
医疗保险和固定的医疗保健来源不足以确保参加医疗补助计划的墨西哥裔美国人充分利用母婴健康服务。与他们较少使用这些预防性健康服务相关的因素包括子女数量较多、交通问题以及来自其支持系统的帮助较少。
