Factors influencing health care utilization in older Hispanics with diabetes along the Texas-Mexico border.
Little is known about predictors of health care utilization for older Hispanics with chronic conditions. This study aimed to determine: (1) the level of health care access for older Hispanics with type 2 diabetes living in a US-Mexico border area; and (2) personal and health correlates to health care utilization (ie, physician visits, eye care, emergency room [ER] use). This was a cross-sectional study based on a community assessment conducted at a clinic, senior centers, and colonias. Colonias are impoverished neighborhoods with substandard living conditions along the US-Mexico border. Hispanics living in colonias are one of the most disadvantaged minority groups in the United States. The study sample consisted of 249 Hispanics age 60 years and older who have type 2 diabetes. Descriptive analyses, multiple linear regression, and generalized linear models were conducted. Older age (P = 0.02) and affordability of physician fees (P = 0.02) were significant correlates to more frequent physician visits. Factors significantly associated with eye care were being insured (P = 0.001) and reporting high cholesterol (P = 0.005). ER use was significantly associated with younger age (60-64 years old; P = 0.03) and suffering from hypertension (P = 0.02). Those who received diabetes education (P = 0.04) were less likely to use the ER. Identifying patterns of health care utilization services in aging underserved minorities who are disproportionately affected by diabetes may lead to culturally appropriate preventive practices and timely access to health care. Adequate health care access can decrease or delay the onset of diabetes complications in older Hispanics with type 2 diabetes who live along the US-Mexico border.
Department of Social and Behavioral Health, School of Rural Public Health, McAllen Campus, Texas A&M Health Science Center, McAllen, Texas 78503, USA. nmier@tamhsc.edu
Nelda
N
Mier
Xiaohui
X
Wang
Matthew Lee
ML
Smith
David
D
Irizarry
Laura
L
Treviño
Maria
M
Alen
Marcia G
MG
Ory
D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D038622:Internationality; D016014:Linear Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology