Perceived Quality of Care, Receipt of Preventive Care, and Usual Source of Health Care Among Undocumented and Other Latinos
Perceived Quality of Care, Receipt of Preventive Care, and Usual Source of Health Care Among Undocumented and Other Latinos
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DOI：
10.1007/s11606-009-1098-2
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发表时间：
2009-11-01
影响因子：
5.7
通讯作者：
Ang, Alfonso
中科院分区：
文献类型：
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作者：
Rodriguez, Michael A.;Bustamante, Arturo Vargas;Ang, Alfonso
拉丁美洲人是美国最大的少数民族群体，在获得医疗保健和医疗保健质量方面持续存在差距。(1)确定出生/移民身份与自我报告的护理和预防护理质量之间的关系。(2)为了评估一个通常的卫生保健来源对接受预防保健的影响在Latinos.Using横断面数据从2007年皮尤西班牙裔中心/罗伯特伍德约翰逊基金会西班牙裔医疗保健调查，全国代表性的电话调查4,013拉丁美洲成年人，我们比较了美国出生的拉丁美洲人与外国出生的拉丁美洲公民，外国出生的拉丁美洲永久居民和无证拉丁美洲人。我们使用单独的多变量有序logistic模型估计了5种结局的比值比：过去2年检查的血压、过去5年检查的胆固醇、过去一年感知的医疗护理质量、过去一年感知的未从医生处收到健康/健康护理信息，和语言一致性。无证拉丁美洲人的保险覆盖率最低（37% vs 77%美国出生，P < 0.001），常规护理来源（58% vs 79%美国出生，P < 0.001），检查血压（67%对87%美国出生，P < 0.001），胆固醇检查（56%对83%美国出生，P < 0.001），并报告在过去一年中的优秀/良好护理（76%对80%美国出生，P < 0.05）。在过去的一年里，无证拉丁美洲人也报告说没有从医生那里得到健康/医疗保健信息的比例最高（40%对20%的美国出生者，P < 0.001）。调整后的结果显示，无证状态与过去2年内检查血压的可能性较低相关（OR = 0.60; 95%CI，0.43-0.84），近5年检查胆固醇（OR = 0.62; 95%CI，0.39-0.99），以及过去一年中接受极好/良好护理的感觉（OR = 0.56; 95%CI，0.39-0.77）。有一个通常的护理来源增加了血压检查的可能性在过去2年和胆固醇检查在过去5年中，在这个国家的样本，无证拉丁美洲人不太可能报告接受血压和胆固醇水平检查，不太可能报告已收到优秀/良好的护理质量，更有可能从医生那里收到没有健康/医疗保健信息，即使在调整了潜在的混杂因素之后。我们的研究表明，在出生/移民身份的差异，应考虑到当我们讨论感知质量的照顾拉丁美洲人。
Latinos are the largest minority group in the United States and experience persistent disparities in access to and quality of health care.(1) To determine the relationship between nativity/immigration status and self-reported quality of care and preventive care. (2) To assess the impact of a usual source of health care on receipt of preventive care among Latinos.Using cross-sectional data from the 2007 Pew Hispanic Center/Robert Wood Johnson Foundation Hispanic Healthcare Survey, a nationally representative telephone survey of 4,013 Latino adults, we compared US-born Latinos with foreign-born Latino citizens, foreign-born Latino permanent residents and undocumented Latinos. We estimated odds ratios using separate multivariate ordered logistic models for five outcomes: blood pressure checked in the past 2 years, cholesterol checked in the past 5 years, perceived quality of medical care in the past year, perceived receipt of no health/health-care information from a doctor in the past year, and language concordance.Undocumented Latinos had the lowest percentages of insurance coverage (37% vs 77% US-born, P < 0.001), usual source of care (58% vs 79% US-born, P < 0.001), blood pressure checked (67% vs 87% US-born, P < 0.001), cholesterol checked (56% vs 83% US-born, P < 0.001), and reported excellent/good care in the past year (76% vs 80% US-born, P < 0.05). Undocumented Latinos also reported the highest percentage receiving no health/health-care information from their doctor (40% vs 20% US-born, P < 0.001) in the past year. Adjusted results showed that undocumented status was associated with lower likelihood of blood pressure checked in the previous 2 years (OR = 0.60; 95% CI, 0.43-0.84), cholesterol checked in the past 5 years (OR = 0.62; 95% CI, 0.39-0.99), and perceived receipt of excellent/good care in the past year (OR = 0.56; 95% CI, 0.39-0.77). Having a usual source of care increased the likelihood of a blood pressure check in the past 2 years and a cholesterol check in the past 5 years.In this national sample, undocumented Latinos were less likely to report receiving blood pressure and cholesterol level checks, less likely to report having received excellent/good quality of care, and more likely to receive no health/health-care information from doctors, even after adjusting for potential confounders. Our study shows that differences in nativity/immigration status should be taken into consideration when we discuss perceived quality of care among Latinos.