Changes in medical care experiences of racial and ethnic groups in the United States, 1996-2002.
The authors examined changes in medical care experiences of racial/ethnic groups (non-Hispanic white, Asian and Pacific Islander, Hispanic, and non-Hispanic black) between 1996 and 2002, using data from the Household Component of Medical Expenditure Panel Surveys. Proportions and adjusted odds ratios for each group's primary care experience are presented. Comparisons are made between groups at each time period and within groups between the two time periods. Multivariable analyses control for demographic and socioeconomic characteristics, health care needs and source of care, and health insurance. Racial/ethnic minorities experienced worse medical care than non-Hispanic whites, but results differed among groups. Non-Hispanic blacks were no different from non-Hispanic whites and showed a slight improvement over time, except for lower odds of having a usual source of care and worse sociodemographic and health indicators. Hispanics had worse experiences than whites in 5 of 8 indicators in 2002 (vs. 3 in 1996). Asians assessed their experience as worse than that of whites in 6 of 8 indicators in 2002 (vs. 3 in 1996), yet had higher self-rated health and education than non-Hispanic whites. Disparities in medical care experience have increased for some groups, and efforts must be made to reduce financial and nonfinancial barriers to care for racial/ethnic minority populations.
Shi
Leiyu
L
Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. lshi@jhsph.edu
Macinko
James
J
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001213:Asian / Q000523:psychology; D003266:Continuity of Patient Care; D005006:Ethnicity / Q000145:classification / Q000523:psychology*; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000145:classification / Q000523:psychology*; D017060:Patient Satisfaction / Q000208:ethnology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D044469:Racial Groups / Q000145:classification / Q000523:psychology*; D014481:United States; D044465:White People / Q000523:psychology; D055815:Young Adult