Barriers to care among American Indians in public health care programs
Barriers to care among American Indians in public health care programs
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DOI：
10.1097/01.mlr.0000215901.37144.94
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发表时间：
2006-06-01
期刊：
影响因子：
3
通讯作者：
Song, Yunjie
中科院分区：
文献类型：
--
作者：
Call, Kathleen Thiede;McAlpine, Donna D.;Song, Yunjie
目的：我们试图研究在何种程度上报告的障碍，以医疗保健服务之间的差异美洲印第安人（AI）和非西班牙裔白人（Whites）.Methods：明尼苏达州的医疗保健计划登记的全州分层随机样本进行了调查。使用逻辑回归模型分析了AI和白色成人入组者（n = 1281）和儿童入组者（n = 572）的父母的反应，该模型解释了复杂的样本设计。审查的障碍包括：财务，访问，和文化障碍，信心/信任提供者，和discrimination.Results：无论是AI和白人报告的障碍，获得医疗保健。然而，更多比例的认可机构报告了大多数类别的障碍。在成年人中，AI更有可能报告种族歧视，文化误解，家庭/工作责任和交通困难，而白人更有可能报告无法看到他们首选的医生。与儿童入学者的父母相比，成年入学者的比例更高，报告了大多数类别的障碍;然而，人工智能和白色儿童的父母之间的差异更大。除了种族歧视和文化误解外，AI儿童的父母比白色登记者的父母更有可能报告有限的诊所时间，缺乏医疗服务。人工智能和白人之间的重大差异涉及信任，尊重和歧视问题。提供者必须解决人工智能所遇到的障碍，以提高人工智能医疗保健消费者的可及性、可接受性和护理质量。
Objective: We sought to examine the extent to which reported barriers to health care services differ between American Indians (AIs) and non-Hispanic Whites (Whites).Methods: A statewide stratified random sample of Minnesota health care program enrollees was surveyed. Responses from AI and White adult enrollees (n = 1281) and parents of child enrollees (n = 572) were analyzed using logistic regression models that account for the complex sample design. Barriers examined include: financial, access, and cultural barriers, confidence/trust in providers, and discrimination.Results: Both AIs and Whites report barriers to health care access. However, a greater proportion of AIs report barriers in most categories. Among adults, AIs are more likely to report racial discrimination, cultural misunderstandings, family/work responsibilities, and transportation difficulties, whereas Whites are more likely to report being unable to see their preferred doctor. A higher proportion of adult enrollees compared with parents of child enrollees report barriers in most categories; however, differences between parents of AIs and White children are more substantial. In addition to racial discrimination and cultural misunderstandings, parents of AI children are more likely than parents of White enrollees to report limited clinic hours, lack ofConclusions: Although individuals have enrolled in health care programs and have access to care, barriers to using these services remain. Significant differences between AIs and Whites involve issues of trust, respect, and discrimination. Providers must address barriers experienced by AIs to improve accessibility, acceptability, and quality of care for AI health care consumers.