An evaluation of racial and ethnic disparities in the utilization of health care services: The impact of patient perceived cultural barriers on the utilization of medical care.
详细信息
- 作者：Edwards ; Kevan Ross.
- 学历：Doctor
- 年：2010
- 导师：Leik, Robert K.,eadvisor
- 毕业院校：University of Minnesota
- ISBN：9781124321615
- CBH：3431587
- Country：USA
- 语种：English
- FileSize：8072743
- Pages：206
文摘
Research continues to show that health and healthcare are unequally distributed resulting in disparities across varied social strata. This issue continues to be of significant importance to policy makers, health services researchers and medical sociologists. As a result of this focus, numerous theories and models of health and health care behavior have emerged during the latter half of the 20th century. In many of these efforts the underlying factor attributed to these disparities is differences in socioeconomic status between those of different races or cultures. Other research in this area however, shows that substantial racial and/or ethnic disparities remain even after controlling for differences in socioeconomic status variables such as income, education, and the presence of health insurance (i.e., a racial residual affect). Explaining this residual racial affect is often difficult and researchers often seem content to point out its existence without offering any actionable explanations. Given the current national focus on the elimination of health disparities such findings and explanation are relevant to those making health policy. This study seeks an explanation for these disparities by examining the impact of patient perceived cultural barriers, on the use of health services. The basic notion is that if members of racial minorities perceive that the medical community discriminates against members of their race, or they some how feel alienated by and unable to manage the healthcare system then they are less likely to use health services. This study examines differences in the utilization of eight different medical preventive services including ambulatory care, physical examination, uterine cancer screening, mammography, screening for blood pressure, colon cancer, prostrate cancer, and high cholesterol using the Andersen behavioral model of health care with data from 2001. Results support the notion that adding cultural influence indicators to the Andersen model somewhat improves the performance of the model for predicting utilization of routine medical services but has negligible impact on more invasive procedures. The importance of a regular source of care in this dynamic is also notable. Beyond the academic question of the role of race and culture in health care utilization, these findings have practical application at several levels (local, regional, state, national) as well as quality improvement efforts within provider organizations enhancing health care access and efficacy by educating providers how to better relate to patients of racial or ethnic backgrounds different from their own.