Vulnerability and unmet health care needs - The influence of multiple risk factors
Vulnerability and unmet health care needs - The influence of multiple risk factors
复制标题
DOI：
10.1111/j.1525-1497.2005.40136.x
复制
发表时间：
2005-02-01
影响因子：
5.7
通讯作者：
Stevens, GD
中科院分区：
文献类型：
--
作者：
Shi, LY;Stevens, GD
背景：以前的研究已经证明了少数民族，低社会经济地位（SES）和缺乏潜在的护理机会（e）之间的密切联系。例如，在一个实施例中，没有保险，也没有固定的护理来源），以及得不到保健服务。大多数研究已经审查了这些风险因素的独立影响差访问，但更实际的模型需要考虑到集群的多个risk.Objective：提出一个配置文件的风险因素差访问的基础上收入，保险覆盖范围，并有一个定期的护理来源，并检查协会的配置文件与未满足的医疗保健需求，由于成本。通过种族/种族来检查关系。设计：分析来自2000年国家健康访谈调查的32，374名成年人。主要结果指标：报告的未满足的需求，由于成本：缺失/延迟所需的医疗保健，延迟获得处方，精神卫生保健或牙科保健。结果：控制个人人口统计和社区因素，低收入，无保险，和没有固定的保健来源的人更有可能由于费用而错过或推迟所需的保健服务。在控制了这些风险因素后，白人比其他种族/族裔群体更有可能报告未满足的需求。当作为一个风险配置文件，一个明确的梯度存在的可能性，有一个未满足的需求，根据风险因素的数量，无论种族/ethnic group.CONCLUSION：未满足的医疗保健需求，由于成本增加，风险配置文件为每个种族和民族。如果不注意这些同时出现的难以获得保健服务的风险因素，就不可能在确保弱势人口获得所需保健服务方面大幅减少差距。
CONTEXT: Previous studies have demonstrated a strong association between minority race, low socioeconomic status (SES), and lack of potential access to care (e. g., no insurance coverage and no regular source of care) and poor receipt of health care services. Most studies have examined the independent effects of these risk factors for poor access, but more practical models are needed to account for the clustering of multiple risks.OBJECTIVE: To present a profile of risk factors for poor access based on income, insurance coverage, and having a regular source of care, and examine the association of the profiles with unmet health care needs due to cost. Relationships are examined by race/ethnicity.DESIGN: Analysis of 32,374 adults from the 2000 National Health Interview Survey.MAIN OUTCOME MEASURES: Reported unmet needs due to cost: missing/delaying needed medical care, and delaying obtaining prescriptions, mental health care, or dental care.RESULTS: Controlling for personal demographic and community factors, individuals who were low income, uninsured, and had no regular source of care were more likely to miss or delay needed health care services due to cost. After controlling for these risk factors, whites were more likely than other racial/ethnic groups to report unmet needs. When presented as a risk profile, a clear gradient existed in the likelihood of having an unmet need according to the number of risk factors, regardless of racial/ethnic group.CONCLUSION: Unmet health care needs due to cost increased with higher risk profiles for each racial and ethnic group. Without attention to these co-occurring risk factors for poor access, it is unlikely that substantial reductions in disparities will be made in assuring access to needed health care services among vulnerable populations.