Use of Preventive Care Services Among Latino Subgroups
Use of Preventive Care Services Among Latino Subgroups
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DOI：
10.1016/j.amepre.2010.01.029
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发表时间：
2010-06-01
影响因子：
5.5
通讯作者：
Ortega, Alexander N.
中科院分区：
文献类型：
--
作者：
Bustamante, Arturo Vargas;Chen, Jie;Ortega, Alexander N.
背景：以前的研究表明，拉美裔和非拉美裔白人在获得和接受预防性护理方面存在明显差距。然而，当拉美裔人比较不同的种族和民族时，这项研究的大部分工作都将他们聚集在一起。目前没有关于主要拉丁裔亚群预防保健利用的一致性的信息。目的：本研究测试三组预防保健服务，以分析美国拉丁裔和非拉丁裔白人最大亚群中成人预防保健接受的主要决定因素。研究还考察了可观测因素和未观测因素在解释预防保健服务提供差异方面的贡献。方法：在2009年合并了2000年至2006年的医疗费用小组调查和国家健康访谈调查。样本包括28,781名拉丁裔和78,979名非拉丁裔白人。这项研究比较了接受成人预防护理服务的差异，并单独检查了提供最具成本效益的预防服务的差异。多变量模型对混杂因素进行了调整。结果：与非拉丁裔白人和其他拉丁裔亚群相比，墨西哥裔和中南美洲血统的拉丁裔接受指南推荐的预防保健服务的可能性要小得多。在最具成本效益的预防保健服务方面，观察到的差异更大：戒烟建议、结直肠癌筛查和流感疫苗接种。观察到的因素占不同措施差异的更大比例(33%-100%)，缺乏医疗保险覆盖范围和没有通常的护理来源是解释差异的最大和最一致的因素。结论：医疗保险覆盖范围的扩大和拉美人更多地融入初级保健实践可以大大减少接受预防保健服务的差异。预防保健倡议应优先考虑在墨西哥和中南美洲血统的拉丁美洲人中提供具有成本效益的服务。(Am J Prey Med 2010；38(6)：610 619)(C)2010年美国预防医学杂志
Background: Previous studies demonstrate a clear gap in access and receipt of preventive care between Latinos and non-Latino whites. Most of this work, however, pools Latinos together when they compare different racial and ethnic groups. There is currently no information about the consistency of preventive care utilization across major Latino subgroups.Purpose: This study tests for three bundles of preventive care services to analyze the main determinants of adult preventive care receipt among the largest subgroups of U.S. Latinos and non-Latino whites. It also examines the contribution of observed and unobserved factors in explaining differences in the provision of preventive care services.Methods: The Medical Expenditure Panel Survey and the National Health Interview Survey from 2000 to 2006 were merged in 2009. The sample consisted of 28,781 Latinos and 78,979 non-Latino whites. This study compared disparities in the receipt of adult preventive care services and separately examined differences in the provision of the most cost-effective preventive services. Multivariate models adjust for confounding factors. The decomposition technique was used to parse out differences into observed and unobserved components.Results: Latinos of Mexican and Central/South American origin are much less likely to receive guideline-recommended preventive care services than non-Latino whites and other Latino subgroups. Larger disparities were observed for the most cost-effective preventive care services: smoking-cessation advice, colorectal cancer screening, and influenza vaccination. Observed factors accounted for a larger share of disparities across measures (33%-100%), with lack of health insurance coverage and not having a usual source of care as the largest and most consistent factors explaining disparities.Conclusions: Health insurance coverage expansion and more integration of Latinos into primary care practices can substantially reduce disparities in the receipt of preventive care services. Preventive care initiatives should prioritize the availability of cost-effective services among Latinos of Mexican and Central/South American heritage. (Am J Prey Med 2010;38(6):610 619) (C) 2010 American Journal of Preventive Medicine