Wagner TH, Guendelman S; Association for Health Services Research. Meeting.
Abstr Book Assoc Health Serv Res Meet. 1998; 15: 28.
School of Public Health, University of California, Berkeley 94720-7360, USA.
RESEARCH OBJECTIVES: Research in the last three decades underscores the problems that Hispanics face accessing health services. Given the proliferation of managed care programs and the heavy influx of newcomers into the U.S. in recent years, an assessment of the health system's responsiveness to diverse Hispanic subpopulations is timely. This study examined patterns of health care utilization among a representative sample of Mexican Americans, Puerto Ricans and Hispanics of other national origins. The assessment focused on the effects of socioeconomic, structural and cultural/migratory factors, perceived experiences with the health care system, and health status on several dimensions of utilization. STUDY DESIGN: Five indicators of health care utilization in the last twelve months were assessed: (1) entry into health care system; (2) volume of utilization; (3) inpatient hospital admission; (4) use of emergency care without being hospitalized; and (5) receipt of preventive care. Data were obtained from the Commonwealth Fund Survey of Minority Health that was conducted by Louis Harris in 1994. The analytic sample for the study was restricted to the 1,001 subjects of Hispanic origin. Weights were used to generate population estimates. PRINCIPLE FINDINGS: The findings indicate that 78% of the adult Hispanics surveyed entered the health care system in the past year, making an average of 5.3 visits (median 3). There was great similarity across the Hispanic sub-populations in the utilization of health care services. However, after adjusting for financial, structural, perceptual, health status, and cultural factors, Puerto Ricans were more likely to use the emergency room than the other two sub-populations, and other Hispanics were more likely to get preventive care than Mexican Americans or Puerto Ricans. Also U.S. born and English speaking Hispanics were more likely to receive preventive vare than foreign born or Spanish speaking Hispanics. Subjective experiences indicating poor treatment were consistently related to an increased utilization of care. CONCLUSIONS: Overall utilization rates for Hispanics have been relatively stable over the past two decades. The findings indicate that while having health insurance and a regular source of care are important, acculturation and subjective experiences with the health care system also influence utilization among ethnic groups. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Since over 40% of the survey respondents lacked a regular source of care, large improvements in health care system responsiveness and satisfaction with care would require access to a regular source of care. Unfortunately, political and welfare reforms that limit health insurance benefits are constraining these opportunities for Hispanics. Nonetheless, access to a regular source of care may be improved with the expansion of managed care programs, especialy in urban areas where such plans are removing cultural barriers.
Publication Types:
Keywords:
- Acculturation
- Adult
- Data Collection
- Ethnic Groups
- European Continental Ancestry Group
- Health Services
- Health Services Accessibility
- Health Status
- Health Surveys
- Hispanic Americans
- Humans
- Insurance, Health
- Managed Care Programs
- Mexican Americans
- Minority Groups
- United States
- economics
- organization & administration
- utilization
- hsrmtgs
Other ID:
UI: 102234054
From Meeting Abstracts