Hispanic/White Differences in Self-reported Hlth Status

目的：先前的研究一致表明，与白人相比，西班牙裔更有可能自我报告较差的整体健康状况。然而，在解释这些变化时，尚不清楚这些研究是否充分控制了重要的协变量。本研究提出(1)确定使用一套更完整的社会经济和健康协变量是否有助于解释西班牙裔自我报告整体健康（SROH）的观察差异，以及这种差异是否因性别而异；(2)在调整其他协变量后，确定SROH对(a)西班牙裔和非西班牙裔白人的医生就诊和(b)住院是否具有相同的预测价值。方法：1992年的健康和退休研究浪潮是由国家老龄化研究所赞助的一项具有全国代表性的51-61岁成年人的研究，将用于分析7169名白人，895名西班牙裔和1652名黑人受访者的数据。多元回归分析（OLS回归、逻辑回归和有序逻辑回归）将用于调查上述目标。主要的因变量是(1)SROH，过去12个月的任何医生就诊，医生就诊次数，以及过去12个月的任何住院。意义：由于SROH通常用于确定人群和个体患者的健康需求，因此本研究对卫生保健提供者、付款人和政策制定者具有实际意义。这项拟议的研究将增加我们对我国增长最快的少数民族人口的健康状况和保健需求的了解。最后，我们相信，这个项目是迈向一个更大项目的重要的第一步，该项目旨在探索和描述几个西班牙裔亚群体在医疗保健价值观、信仰和使用方面的变化，并基于这些群体更客观的健康状况测量来验证健康状况的替代测量。

Aims: Prior studies have consistently shown that Hispanics are more likely to self-report poorer overall health status compared to whites. However, it is unclear whether these studies have adequately controlled for important covariates when explaining these variations. This study proposes to (1) determine if using a more complete set of socioeconomic and health covariates can help explain the observed differentials in Hispanic self-reported overall health (SROH) and whether this difference varies according to gender; and (2) determine whether SROH has the same predictive value for (a) physician visits and (b) hospitalization for Hispanics and non-Hispanic whites, after adjusting for other covariates. Methods: The 1992 wave of the Health and Retirement Study, a nationally representative study of 51-61 year old adults, sponsored by the National Institute of Aging, will be used to analyze data on 7169 white, 895 Hispanic, and 1652 black respondents. Multivariate regression analysis (OLS regression, logistic regression, and ordered logistic regression) will be used to investigate the above aims. The main dependent variables will be (1) SROH, any physician visit in past 12 months, number of physician visits, and any hospitalization in the past 12 months. Significance: This research is of practical use for health care providers, payors, and policy makers, as SROH is often used to determine the health needs of both populations and individual patients. This proposed study would add to our knowledge regarding the health status and health care needs of our fastest growing ethnic population. Lastly, we are convinced that this project is an essential first step toward a larger project designed to explore and describe variations in health care values, beliefs, and use among several Hispanic subgroups, and to validate alternative measures of health status based on more objective measures of health status for these groups.