title: The healthcare experiences of Koreans living in North Carolina: a mixed methods study.
abstract: This study examined the healthcare experiences of Korean immigrants aged 40-64 living in the North Carolina Triangle area of the Southeastern United States. Using a mixed methods design, we collected quantitative data via a questionnaire from 125 participants and conducted a focus group with 10 interviewees from December 2010 to February 2011. The quantitative data were analysed using t-tests and chi-square tests, and a thematic analysis was used for the focus group study. Questionnaire findings showed that only 27.2% had sufficient English skills to communicate adequately. Participants with insurance were significantly more likely to be employed (P < 0.001), had higher incomes (P = 0.011) and higher education (P < 0.001), and had greater English-speaking ability (P = 0.011) than those without insurance. Participants who did not use healthcare services showed significantly less knowledge (P < 0.001) of and less satisfaction (P = 0.034) with the healthcare system than those using healthcare services. Sixty-two participants (49.6%) reported having no health insurance for one or more of the following reasons: high costs (75.8%), medical tourism (22.6%) and lack of information or knowledge (6.5%). The following themes emerged from the data collected during the focus group: (i) barriers to utilisation of healthcare services; (ii) facilitators of utilisation of healthcare services; and (iii) social support seeking for health management. Our mixed methods study findings indicate that healthcare disparities exist among Korean immigrants and that a number of factors, including health literacy, may contribute to their poor health outcomes. Continued collaboration among community members, healthcare professionals and academicians is needed to discuss the community's health concerns and to develop sustainable programmes that will ensure meaningful access to care for those with limited English proficiency and medically underserved populations.
authors.affiliation: School of Nursing, Duke University, Durham, NC, USA.
authors.forename: Jennie C
authors.initials: JC
authors.lastname: De Gagne
authors.forename: Jina
authors.initials: J
authors.lastname: Oh
authors.forename: Aeyoung
authors.initials: A
authors.lastname: So
authors.forename: Suk-Sun
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000328:Adult; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D057220:Health Literacy; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D017060:Patient Satisfaction / Q000208:ethnology; D056910:Republic of Korea / Q000208:ethnology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: community health care; cultural sensitivity; ethnic minorities; ethnicity and health; health services; mixed methodologies