Your browser doesn't support javascript.
loading
Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act.
Chen, Jie; Vargas-Bustamante, Arturo; Mortensen, Karoline; Ortega, Alexander N.
Afiliação
  • Chen J; *Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD †Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA ‡Department of Health Sector Management & Policy, School of Business Administration, University of Miami, Coral Gables, FL §Department of Health Management & Policy, Drexel University Dana and David Dornsife School of Public Health, Philadelphia, PA.
Med Care ; 54(2): 140-6, 2016 Feb.
Article em En | MEDLINE | ID: mdl-26595227
OBJECTIVE: To examine racial and ethnic disparities in health care access and utilization after the Affordable Care Act (ACA) health insurance mandate was fully implemented in 2014. RESEARCH DESIGN: Using the 2011-2014 National Health Interview Survey, we examine changes in health care access and utilization for the nonelderly US adult population. Multivariate linear probability models are estimated to adjust for demographic and sociodemographic factors. RESULTS: The implementation of the ACA (year indicator 2014) is associated with significant reductions in the probabilities of being uninsured (coef=-0.03, P<0.001), delaying any necessary care (coef=-0.03, P<0.001), forgoing any necessary care (coef=-0.02, P<0.001), and a significant increase in the probability of having any physician visits (coef=0.02, P<0.001), compared with the reference year 2011. Interaction terms between the 2014 year indicator and race/ethnicity demonstrate that uninsured rates decreased more substantially among non-Latino African Americans (African Americans) (coef=-0.04, P<0.001) and Latinos (coef=-0.03, P<0.001) compared with non-Latino whites (whites). Latinos were less likely than whites to delay (coef=-0.02, P<0.001) or forgo (coef=-0.02, P<0.001) any necessary care and were more likely to have physician visits (coef=0.03, P<0.005) in 2014. The association between year indicator of 2014 and the probability of having any emergency department visits is not significant. CONCLUSIONS: Health care access and insurance coverage are major factors that contributed to racial and ethnic disparities before the ACA implementation. Our results demonstrate that racial and ethnic disparities in access have been reduced significantly during the initial years of the ACA implementation that expanded access and mandated that individuals obtain health insurance.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Etnicidade / Cobertura do Seguro / Grupos Raciais / Patient Protection and Affordable Care Act / Acessibilidade aos Serviços de Saúde / Seguro Saúde Tipo de estudo: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality / Implementation_research Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Med Care Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Etnicidade / Cobertura do Seguro / Grupos Raciais / Patient Protection and Affordable Care Act / Acessibilidade aos Serviços de Saúde / Seguro Saúde Tipo de estudo: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality / Implementation_research Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Med Care Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos