Sexual orientation-related disparities in healthcare access in three cohorts of U.S. adults.
Sexual orientation-related disparities in healthcare access in three cohorts of U.S. adults.
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DOI：
10.1016/j.ypmed.2020.105999
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发表时间：
2020-03
影响因子：
5.1
通讯作者：
Charlton BM
中科院分区：
文献类型：
--
作者：
Tabaac AR;Solazzo AL;Gordon AR;Austin SB;Guss C;Charlton BM
本研究的目的是量化性取向在保险获取，医疗保健利用和未满足的护理需求方面的差异。我们分析了美国三个纵向的横截面数据-在2015年至2019年的《今日成长研究1》和《今日成长研究2》以及《护士健康研究3》中，对年龄在20-54岁之间的成年人进行了基于队列（N = 31，172）的研究。调整后的对数二项模型研究了性取向差异（参考：完全异性恋）在保险获得，医疗保健利用和未满足的护理需求。与完全异性恋者相比，大多数异性恋和双性恋成年人更有可能报告急诊室作为通常的护理来源，而不太可能购买私人保险。性少数群体（主要是异性恋，双性恋，男同性恋/女同性恋）也比完全异性恋者更有可能推迟所需的护理，原因是不想打扰医疗保健提供者，对成本/保险的担忧，以前的医疗保健经验不好，以及无法预约。性别和性取向的差异也出现了医疗保健利用和未满足的需求。例如，大多数异性恋女性比完全异性恋的女性更有可能因为认为症状不够严重而推迟护理，而男同性恋者比女同性恋者更不可能因为这个原因而推迟。调查结果表明，性少数群体的经验差距，在未满足的需求和连续性的照顾。提供者的教育应该注意如何感知，如感知的严重性，可以塑造医疗保健的访问与社会经济障碍。
The objective of this study was to quantify sexual orientation differences in insurance access, healthcare utilization, and unmet needs for care. We analyzed cross-sectional data from three longitudinal U.S.-based cohorts (N = 31,172) of adults ages 20–54 years in the Growing Up Today Studies 1 and 2 and the Nurses’ Health Study 3 from 2015 to 2019. Adjusted log-binomial models examined sexual orientation differences (reference: completely heterosexual) in insurance access, healthcare utilization, and unmet needs for care. Compared to completely heterosexuals, mostly heterosexual and bisexual adults were more likely to report emergency departments as a usual source of care and less likely to be privately insured. Sexual minorities (mostly heterosexual, bisexual, gay/lesbian) were also more likely than completely heterosexuals to delay needed care for reasons of not wanting to bother a healthcare provider, concerns over cost/insurance, bad prior healthcare experiences, and being unable to get an appointment. Differences by sex and sexual orientation also emerged for healthcare utilization and unmet needs. For example, mostly heterosexual women were more likely than completely heterosexual women to delay care due to perceiving symptoms as not serious enough, while gay men were less likely than lesbian women to delay for this reason. Findings indicate that sexual minorities experience disparities in unmet needs for and continuity of care. Provider education should be attentive to how perceptions, like perceived severity, can shape healthcare access in tandem with socioeconomic barriers.
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影响因子：
2.9
作者：
Charlton BM;Gordon AR;Reisner SL;Sarda V;Samnaliev M;Austin SB
通讯作者：
Austin SB
影响因子：
4.8
作者：
Macapagal, Kathryn;Bhatia, Ramona;Greene, George J.
通讯作者：
Greene, George J.
影响因子：
4.8
作者：
Blosnich, John R.
通讯作者：
Blosnich, John R.
影响因子：
3.2
作者：
Austin, Erika Laine;Irwin, Jay A.
通讯作者：
Irwin, Jay A.
影响因子：
5
作者：
ANDERSEN, RM
通讯作者：
ANDERSEN, RM