Kitty S Chan1,2, Megha A Parikh3, Roland J Thorpe4,5, Darrell J Gaskin4,3. 1. Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. kitty.s.chan@medstar.net. 2. Medstar Health Research Institute, 3800 Reservoir Rd., NW, Gorman 3056, Washington, DC, 20007, USA. kitty.s.chan@medstar.net. 3. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 4. Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 5. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
OBJECTIVES: To examine disparities in use and access to different health care providers by community and individual race-ethnicity and to test provider supply as a potential mediator. DATA SOURCES: National secondary data from 2014 Medical Expenditure Panel Survey, 5-year estimates (2010-2014) from American Community Survey, and 2014 InfoUSA. STUDY DESIGN: Multiple logistic regression models examined the association of community and individual race-ethnicity with reported health care visits and access. Mediation analyses tested the role of provider supply. DATA EXTRACTION METHODS: Individual-level survey data were linked to race-ethnic composition and health business counts of the respondent's primary care service area (PCSA). PRINCIPAL FINDINGS: Minority PCSAs are significantly and independently associated with lower odds of having a visit to a physician assistant/nurse practitioner, dentist, or other health professionals and having a usual care provider (all p < 0.05). Few significant associations were observed for integrated PCSAs or for health provider supply. A modest mediation effect for provider supply was observed for travel time to usual care provider and visit to other health professionals. CONCLUSIONS: Use of a range of health services is lower in minority communities and individuals. However, provider supply was not an important explanatory factor of these disparities.
OBJECTIVES: To examine disparities in use and access to different health care providers by community and individual race-ethnicity and to test provider supply as a potential mediator. DATA SOURCES: National secondary data from 2014 Medical Expenditure Panel Survey, 5-year estimates (2010-2014) from American Community Survey, and 2014 InfoUSA. STUDY DESIGN: Multiple logistic regression models examined the association of community and individual race-ethnicity with reported health care visits and access. Mediation analyses tested the role of provider supply. DATA EXTRACTION METHODS: Individual-level survey data were linked to race-ethnic composition and health business counts of the respondent's primary care service area (PCSA). PRINCIPAL FINDINGS: Minority PCSAs are significantly and independently associated with lower odds of having a visit to a physician assistant/nurse practitioner, dentist, or other health professionals and having a usual care provider (all p < 0.05). Few significant associations were observed for integrated PCSAs or for health provider supply. A modest mediation effect for provider supply was observed for travel time to usual care provider and visit to other health professionals. CONCLUSIONS: Use of a range of health services is lower in minority communities and individuals. However, provider supply was not an important explanatory factor of these disparities.
Entities:
Keywords:
Ethnic; Health care disparities; Health care provider supply; Racial; Segregation
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