Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer.
Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer.
复制标题
DOI：
10.1097/mlr.0000000000001538
复制
发表时间：
2021-06-01
期刊：
影响因子：
3
通讯作者：
Ortega AN
中科院分区：
文献类型：
--
作者：
Park S;Chen J;Ma GX;Ortega AN
亚裔美国人的癌症筛查率低于非拉丁裔“白人”，这表明亚裔美国人在癌症预防方面存在不平等。关于白人和亚裔美国人癌症治疗的不公平性知之甚少。利用2002-2017年医疗支出小组调查，我们研究了白人和亚裔美国人之间在获得医疗保健和医疗保健支出方面的不平等。我们的结果包括三项获得医疗保健的措施和三项医疗保健支出的措施。我们使用多变量回归，同时调整诱发因素、使能因素和需求因素，并估计每组结果的平均调整值。然后，我们研究了亚裔美国人相对于白人在这些调整后的平均结果中的差异。我们观察到不公平的证据，即没有癌症的亚裔美国人由于缺乏通常的护理来源而获得的护理有限。没有癌症的亚裔美国人获得常规护理的可能性低于没有癌症的白人。在亚裔美国人癌症患者中没有观察到不平等现象。与白人癌症患者相比，亚裔美国人癌症患者获得护理的水平相似或更好。白人和亚裔美国人癌症患者的医疗保健支出没有差异或差异很小。这些发现在非老年组和老年组中是一致的。虽然没有癌症的亚裔美国人由于获得护理的机会有限而无法满足医疗需求，但白人和亚裔美国人之间的护理和支出相对公平。
Asian Americans have lower cancer screening rates than non-Latino “whites,” suggesting inequities in cancer prevention among Asian Americans. Little is known about inequities in cancer treatment between whites and Asian Americans with cancer. Using the 2002–2017 Medical Expenditure Panel Survey, we examined inequities in access to care and health care spending between whites and Asian Americans with and without cancer. Our outcomes included three measures of access to care and three measures of health care spending. We used multivariable regressions while adjusting for predisposing, enabling, and need factors and estimated the mean adjusted values of the outcomes for each group. We then examined the differences in these adjusted mean outcomes among Asian Americans relative to whites. We observed evidence of inequities that Asian Americans without cancer experienced limited access to care due to a lack of a usual source of care. The likelihood of having a usual source of care was lower among Asian Americans without cancer than whites without cancer. Inequities were not observed among Asian Americans with cancer. Compared to whites with cancer, Asian Americans with cancer had similar or better levels of access to care. No or marginal differences in health care spending were detected between whites and Asian Americans with cancer. These findings were consistent in both non-elderly and elderly groups. While Asian Americans without cancer have unmet medical needs due to limited access to care, access to care and spending are relatively equitable between whites and Asian Americans with cancer.