Duru OK, Morales L; AcademyHealth. Meeting (2004 : San Diego, Calif.).
Abstr AcademyHealth Meet. 2004; 21: abstract no. 1290.
University of California, Los Angeles, Division of General Internal Medicine, 911 Broxton Plaza, 3rd floor, Los Angeles, CA 90024 Tel. 310.794.8138 Fax
RESEARCH OBJECTIVE: Studies in adult populations have documented that limited English proficiency (LEP) is associated with decreased access to care, and may explain a significant component of racial/ethnic health disparities in utilization. Children depend on parents to access health care on their behalf, and minority children of LEP parents may be less likely to receive appropriate care. Latino children are less likely than white children to receive care, but few analyses have examined the possible unmeasured effect of primary language on children's utilization of care. STUDY DESIGN: Race/language pairings were used as the primary independent variable (white, Latino/English, Latino/Spanish), for three probit regressions predicting the likelihood of a clinic visit in different settings. In the first, we assessed whether the child had a clinic visit in the setting of an acute or chronic illness. In the second, we assessed whether the child had a clinic visit if an appointment had been made. In the third, we assessed whether children under two had any lifetime well child visit or immunization visit. To ease interpretation of our results, we estimated predicted probabilities and standard errors of a clinic visit for children from each race/language pairing. Errors were adjusted to control for clustering by health plans. POPULATION STUDIED: We used 2000/2001 CAHPS survey data on 29,564 children enrolled in 27 health plans participating in the State of California Children's Health Insurance Program. PRINCIPAL FINDINGS: For each analysis, predicted clinic visit rates for white children were significantly higher than for Latino/Spanish children. With an illness, the probability of a visit for white children within six months was 92%, but only 79% for Latino/Spanish children. If an appointment was successfully made, the probability of a visit within six months was 94% for white children as compared to 82% for Latino/Spanish children. The predicted probability of a lifetime well child or immunization visit for children under two years of age was 93% for white children, whereas it was only 79% for Latino/Spanish children. In each case, there was no statistical difference between predicted probabilities for visits by white children and Latino/English children. All reported results were significant at the p<0.05 level. CONCLUSIONS: Within the insured population of children we studied, differences in utilization of care by primary language exist in different situations measuring a perceived or evaluated need for care. These findings suggest that racial/ethnic disparities in utilization of pediatric care between Latinos and whites may in fact reflect issues related to LEP. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Strategies to reduce racial/ethnic disparities in utilization of pediatric care should target parents with limited English proficiency.
Publication Types:
Keywords:
- Adult
- California
- Child
- Child Health Services
- Child Welfare
- Continental Population Groups
- Ethnic Groups
- European Continental Ancestry Group
- Health Care Surveys
- Health Services Needs and Demand
- Hispanic Americans
- Humans
- Insurance, Health
- Language
- Minority Groups
- Parents
- economics
- utilization
- hsrmtgs
UI: 103624324
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