Access to and utilization of health care by subgroups of Latino children.
Access to and utilization of health care by subgroups of Latino children.
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DOI：
10.1097/mlr.0b013e318190d9e4
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发表时间：
2009-06-01
期刊：
影响因子：
3
通讯作者：
Ortega, Alexander N
中科院分区：
文献类型：
--
作者：
Perez, Victor H;Fang, Hai;Ortega, Alexander N
背景：拉丁裔是美国最大的少数族裔儿童群体。尽管拉丁裔儿童存在很大差异，但研究传统上将他们视为一个整体。很少有研究考察不同拉丁裔儿童亚群获得和使用医疗保健的模式和决定因素。 目标：在调整重要的倾向因素、促成因素和需求因素后，描绘白人和拉丁裔儿童亚群之间获得和使用医疗保健模式的差异。研究设计：使用全国健康访谈调查数据（1998-2006）来研究墨西哥、波多黎各、古巴和其他拉丁裔血统的儿童，如还有白人孩子。数据根据增量模型中的诱发因素、促成因素和需求因素进行了调整。我们还进行了其他分析，以测试医疗保险和语言使用的修改对亚组与医疗保健获取和利用之间关联的影响。 结果：发现墨西哥血统的儿童与其他亚组相比，在获得医疗保健和使用服务方面具有最一致的模式。多变量分析表明拉丁裔亚组之间存在持续的变异性。对易感因素、促成因素和需求因素的调整并不能完全解释亚组差异。结论：要了解拉丁裔儿童的医疗保健服务，需要对特定亚组进行进一步检查，而改善获取和利用的干预措施不应仅限于健康保险覆盖范围和语言服务。
BACKGROUND: Latinos make up the largest group of minority children in the United States. Despite great diversity among Latino children, studies have traditionally treated them as a monolithic group. Few studies have examined patterns and determinants of access to and use of health care for different subgroups of Latino children.OBJECTIVES: To delineate differences in access and utilization patterns between white and subgroups of Latino children, after adjusting for important predisposing, enabling, and need factors.RESEARCH DESIGN: National Health Interview Survey data (1998-2006) were used to study children of Mexican, Puerto Rican, Cuban, and other Latino ancestry, as well as white children. Data were adjusted for predisposing, enabling, and need factors in incremental models. Additional analyses were conducted to test for effect modification of health insurance and language use on the associations between the subgroups and health care access and utilization.RESULTS: Children of Mexican ancestry were found to have the most consistent pattern of poorer access to health care and use of services compared with the other subgroups. Multivariate analyses demonstrated persistent variability between Latino subgroups. Adjustment for predisposing, enabling, and need factors did not fully explain subgroup differences.CONCLUSIONS: Efforts to understand health care services for Latino children will require further examination of specific subgroups, and interventions to improve access and utilization should not be limited to health insurance coverage and language services.