RACE, ETHNICITY, AND ACCESS TO AMBULATORY CARE AMONG UNITED-STATES ADOLESCENTS
RACE, ETHNICITY, AND ACCESS TO AMBULATORY CARE AMONG UNITED-STATES ADOLESCENTS
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DOI：
10.2105/ajph.83.7.960
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发表时间：
1993-07-01
影响因子：
12.7
通讯作者：
MCMANUS, MA
中科院分区：
文献类型：
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作者：
LIEU, TA;NEWACHECK, PW;MCMANUS, MA
目标.改善少数群体青少年的健康需要更好地了解影响他们获得和利用保健的因素。本研究描述了白色，黑人和西班牙裔青少年之间的医疗保健的获取和使用的差异，并评估这种差异是如何影响保险。我们使用了1988年全国健康访谈调查中儿童健康补充资料中的7465名10至17岁儿童的数据。黑人（16%）和西班牙裔（28%）没有保险的比例远远高于白人（11%）。尽管报告的健康状况更差，但黑人和西班牙裔青少年在过去一年中的就医次数明显少于他们的白色同龄人，并且更容易缺乏常规和急性护理的常规来源以及护理来源之间的连续性。与白色青年相比，拥有健康保险与少数民族青年获得和使用措施的增加有关。然而，种族差异仍然存在，即使在调整健康保险，家庭收入，需要和其他因素。少数群体青少年特别容易受到影响所有青年的保健问题的影响。虽然健康保险对于增加少数群体青年适当使用医疗保健特别重要，但促进更公平使用的非金融方法也值得进一步研究。
Objectives. Improving the health of minority adolescents will require a better understanding of factors that influence their access to and use of health care. This study describes the differences in health care access and use among White, Black and Hispanic adolescents and evaluates how such differences are influenced by insurance.Methods. We used data on 7465 10- to 17-year-olds included in the child health supplement to the 1988 National Health Interview Survey.Results. Much higher proportions of Blacks (16%) and Hispanics (28%) than of Whites (11%) were uninsured. Despite having worse reported health status, Black and Hispanic adolescents made notably fewer doctor visits in the past year than their White peers, and were more apt to lack usual sources of routine and acute care as well as continuity between sources of care. Having health insurance was associated with greater increases in access and usage measures for minority youth than for White youth. However, racial differences persisted even after adjusting for health insurance, family income, need, and other factors.Conclusions. Minority adolescents are particularly vulnerable to the problems of health care access that affect all youth. While health insurance is especially important for increasing appropriate health care use among minority youth, nonfinancial methods of enabling more equitable use also deserve further study.