Inequities in Patient Access to Care Among Asian American, Native Hawaiian, and Pacific Islander Adults in Medicaid.

Autor: Oh EG; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, 02912, USA. eunhae_oh@brown.edu., Huang AW; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, 02912, USA., Nguyen KH; Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, 02118, USA.
Jazyk: angličtina
Zdroj: Journal of racial and ethnic health disparities [J Racial Ethn Health Disparities] 2024 Oct; Vol. 11 (5), pp. 2538-2552. Date of Electronic Publication: 2023 Jul 25.
DOI: 10.1007/s40615-023-01719-x
Abstrakt: Background: Despite decades of advocacy for disaggregated data collection and reporting for Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) people, significant gaps remain in our ability to understand AA and NHPI individuals' access to care. We assess inequities in access to care measures between non-Hispanic White and AA and NHPI adult Medicaid enrollees.
Methods: We used the 2014-15 Nationwide Adult Medicaid Consumer Assessment of Healthcare Providers and Systems, the first-and-only nationally representative sample of Medicaid enrollees. Our main outcomes were access to needed care, access to a personal doctor, timely access to a checkup, and timely access to specialty care. Using multivariable linear probability models, we assessed the relationship between racial/ethnic group and our outcomes, both in the aggregate and disaggregated into ten racial/ethnic groups, and adjusted for enrollee-level sociodemographic characteristics, health status, and state-level Medicaid expansion status.
Results: In aggregate, AA and NHPI enrollees reported worse access to care than White enrollees on all four metrics (p < 0.001). The magnitude of disparities varied across the ten AA and NHPI ethnic groups. Disparities relative to White enrollees were particularly large in magnitude, roughly 1.5 to 2 times greater, for Chinese, Korean, and Vietnamese enrollees than for the aggregated AA and NHPI group.
Conclusions: Despite comparable insurance coverage, there were inequities in multiple access to care metrics between non-Hispanic White and AA and NHPI Medicaid enrollees. Collection of disaggregated health data on AA and NHPI patients reveals important variation in access to care by ethnic group.
(© 2023. W. Montague Cobb-NMA Health Institute.)
Databáze: MEDLINE
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