Physician Utilization by Three Groups of Ethnic Elderly
Physician Utilization by Three Groups of Ethnic Elderly
复制标题
三类族裔老年人的医生使用情况
作者：
C. Cox
在居住在加利福尼亚州圣克拉拉的越南人、葡萄牙人和西班牙裔三个族群的老年人中，对医生利用的决定因素进行了调查。安徒生和纽曼的行为模型为分析提供了一个框架。单变量分析描述并比较了三组患者的易感因素、使能因素和需要因素，以及与种族有关的因素，如语言和医生的语言。最小二乘回归比较了样本利用率的预测因素。结果表明，需求是医生护理的共同决定因素，但需求的定义因种族而异。样本的慢性病患病率相似，就诊次数相同，但需求和预测利用的因素不同。在婚姻状况对使用率的作用上，不同组之间存在差异。对于葡萄牙人来说，结婚是一个重要的预测因素；而对于西班牙裔人来说，未婚是一个重要的预测因素。对越南人来说，最重要的预测因素是他们对医疗服务的满意度，这一因素对其他样本来说并不显著。这可能表明医生的角色超越了仅仅是为这一人群提供医疗保健的角色。结果表明，种族不一定是护理的障碍，但提供者必须对患者的文化多样性以及他们可能对利用的影响敏感。
Determinants of physician utilization were examined among three groups of ethnic elderly, Vietnamese, Portuguese, and Hispanic, living in Santa Clara, California. Andersen and Newman's1 behavioral model provided a framework for the analysis. Univariate analysis described and compared the three groups in terms of predisposing, enabling, and need factors as well as factors related to ethnicity such as language and language of the physician. Least squares regression compared the predictors of utilization for the samples. The results showed that need is the common determinant of physician care but that the definition of need varies with ethnicity. The samples had similar rates of chronic illnesses and made equal physician visits, but the needs and factors predicting utilization differed. Contrasts were found between groups in the role of marital status on utilization. For the Portuguese, being married was a significant predictor; while for the Hispanics, being unmarried was significant. The most important predictor for the Vietnamese was satisfaction with their medical care, a factor that was not significant for the other samples. This may indicate that the physician's role transcends that of being just a health care provider for this population. The results suggest that ethnicity is not necessarily a barrier to care but that providers must be sensitive to the cultural diversities of patients and the effects they can have on utilization