Access to care for chronic pain: Racial and ethnic differences
Access to care for chronic pain: Racial and ethnic differences
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DOI：
10.1016/j.jpain.2004.12.008
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发表时间：
2005-05-01
期刊：
影响因子：
4
通讯作者：
Portenoy, RK
中科院分区：
文献类型：
--
作者：
Nguyen, M;Ugarte, C;Portenoy, RK
获得医疗保健是一个重大的国家问题，多项调查表明，种族和民族差异影响了慢性疼痛问题的护理机会。为了评估种族和族裔对获得慢性疼痛治疗的影响，我们对具有全国代表性的 454 名白人、447 名非裔美国人和 434 名西班牙裔受试者进行了一项横断面电话调查，受试者的疼痛时间≥ 3 个月。问题探讨了人口统计、疼痛及其治疗以及对获得护理的感知。复合“访问”变量将实际咨询与感知访问结合起来。西班牙裔人更年轻，最不可能投保，受教育程度最低，收入也最低； 61% 的人在家说西班牙语。与白人 (84%) 或非裔美国人 (85%) 相比，西班牙裔 (70%) 因疼痛而咨询初级保健医生的可能性明显较低。咨询可能性较低还与会说西班牙语、男性、相对年轻（18-34 岁）或单身、受教育程度有限以及没有工作有关。获得护理的“机会”少与西班牙裔和说西班牙语、年轻或男性、收入低或教育有限、有工作以及同意经济问题阻碍了疼痛治疗有关。高“接触”与白人或非裔美国人有关；年长或女性或居住在郊区；有保险、较高收入或大学教育；和失业。在多变量模型中，低“获取”与西班牙裔种族有关，并且一致认为经济问题阻碍了疼痛治疗。高“接触”程度与更严重的疼痛、拥有保险或收入在 25,000 美元至 74,000 美元之间以及同意“医生或其他医疗保健提供者是我第一个会去讨论我的疼痛的人”相关。这些数据表明种族/民族、其他人口特征和社会经济因素影响获得疼痛护理的机会。西班牙裔预计获得医疗保健的机会有限。观点：种族和族裔对获得医疗保健的影响是美国的一个主要问题。一项全国电话调查表明，种族和民族以及其他人口和社会经济因素会影响慢性疼痛的护理。 (c) 2005 年，美国疼痛协会。
Access to medical care is a major national issue, and several surveys suggest that racial and ethnic differences influence access to care for chronic pain problems. To evaluate the influence of race and ethnicity on access to treatment for chronic pain, a cross-sectional telephone survey was performed in a nationally representative sample of 454 white, 447 African-American, and 434 Hispanic subjects with pain for >= 3 months. Questions explored demographics, pain and its treatment, and perceived access to care. A composite "access" variable combined actual consultation with perceived access. Hispanics were younger, least likely to be insured, and had the least education and lowest income; 61% spoke Spanish at home. Hispanics were significantly less likely to have consulted a primary care practitioner for pain (70%) than whites (84%) or African-Americans (85%). A lower likelihood of consultation also was associated with speaking Spanish, being male, being relatively young (18-34 years old) or single, having limited education, and not being employed. Low "access" to care was associated with being Hispanic and speaking Spanish, being younger or male, having low income or limited education, being employed, and agreeing that financial concerns prevented pain treatment. High "access" was associated with being white or African-American; being older or female or living in a suburban area; having insurance, higher income, or college education; and being unemployed. In multivariate models, low "access" was associated with Hispanic ethnicity and agreement that financial concerns prevented pain treatment. High "access" was associated with more severe pain, having insurance or an income of $25,000 to $74,000, and agreeing that "A doctor or other health care provider is the first person I would go to to discuss my pain." These data suggest that race/ethnicity, other demographic characteristics, and socioeconomic factors influence access to pain care. Hispanic ethnicity predicts limited access.Perspective: The influence of race and ethnicity on access to health care is a major issue in the United States. A national telephone survey suggests that race and ethnicity, along with other demographic and socioeconomic factors, influence access to care for chronic pain. (c) 2005 by the American Pain Society.