Insurance Coverage, Usual Source of Care, and Receipt of Clinically Indicated Care for Comorbid Conditions Among Adults Living With Human Immunodeficiency Virus

Medical Care ◽  
2005 ◽  
Vol 43 (4) ◽  
pp. 401-410 ◽  
Author(s):  
Ris?? B. Goldstein ◽  
Mary Jane Rotheram-Borus ◽  
Mallory O. Johnson ◽  
Lance S. Weinhardt ◽  
Robert H. Remien ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Insurance Coverage ◽  
Usual Source Of Care ◽  
Comorbid Conditions ◽  
Usual Source ◽  
Immunodeficiency Virus ◽  
Source Of Care

scholarly journals Healthcare Access and Utilization among Korean Americans: The Mediating Role of English Use and Proficiency

2016 ◽  
Vol 4 (1) ◽  
pp. 83 ◽  
Author(s):  
Jiang Li ◽  
Annette E. Maxwell ◽  
Beth A. Glenn ◽  
Alison K. Herrmann ◽  
L Cindy Chang ◽  
...  
Keyword(s):  
Health Insurance ◽  
Length Of Stay ◽  
Health Services ◽  
Insurance Coverage ◽  
Korean Americans ◽  
Usual Source Of Care ◽  
Mediating Role ◽  
Usual Source ◽  
The Us ◽  
Source Of Care

The literature suggests that Korean Americans underutilize health services. Cultural factors and language barriers appear to influence this pattern of low utilization but studies on the relationships among length of stay in the US, English use and proficiency, and utilization of health services among Korean Americans have yielded inconsistent results. This study examines whether English language use and proficiency plays a mediating role in the relationships between length of stay in the US and health insurance coverage, access to and use of care. Structural equation modeling was used for mediation analysis with multiple dependent variables among Korean Americans (N= 555) using baseline data from a large trial designed to increase Hepatitis B testing. The results show 36% of the total effect of proportion of lifetime in the US on having health insurance was significantly mediated by English use and proficiency (indirect effect =0.166, SE= 0.07, p<.05; direct effect=0.296, SE= 0.13, p<.05). Proportion of lifetime in the US was not associated with usual source of care and health service utilization. Instead, health care utilization was primarily driven by having health insurance and a usual source of care, further underscoring the importance of these factors. A focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans has the potential to mitigate health disparities associated with reduced access to health services in this population.

scholarly journals The Case for Synergy Between a Usual Source of Care and Health Insurance Coverage

2011 ◽  
Vol 26 (9) ◽  
pp. 1059-1066 ◽  
Author(s):  
Jennifer E. DeVoe ◽  
Carrie J. Tillotson ◽  
Sarah E. Lesko ◽  
Lorraine S. Wallace ◽  
Heather Angier
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Usual Source Of Care ◽  
Usual Source ◽  
Source Of Care

scholarly journals Racial and Ethnic Disparities in Access to Health Care Among Adults in the United States: A 20-Year National Health Interview Survey Analysis, 1999–2018

2020 ◽  
Author(s):  
César Caraballo ◽  
Dorothy Massey ◽  
Shiwani Mahajan ◽  
Yuan Lu ◽  
Amarnath R. Annapureddy ◽  
...  
Keyword(s):  
Medical Care ◽  
National Health ◽  
National Health Interview Survey ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Usual Source Of Care ◽  
Usual Source ◽  
Interview Survey ◽  
Source Of Care ◽  
Hispanic White

ABSTRACTImportanceRacial and ethnic disparities plague the US health care system despite efforts to eliminate them. To understand what has been achieved amid these efforts, a comprehensive study from the population perspective is needed.ObjectivesTo determine trends in rates and racial/ethnic disparities of key access to care measures among adults in the US in the last two decades.DesignCross-sectional.SettingData from the National Health Interview Survey, 1999–2018.ParticipantsIndividuals >18 years old.ExposureRace and ethnicity: non-Hispanic Black, non-Hispanic Asian, non-Hispanic White, Hispanic.Main outcome and measuresRates of lack of insurance coverage, lack of a usual source of care, and foregone/delayed medical care due to cost. We also estimated the gap between non-Hispanic White and the other subgroups for these outcomes.ResultsWe included 596,355 adults, of which 69.7% identified as White, 11.8% as Black, 4.7% as Asian, and 13.8% as Hispanic. The proportion uninsured and the rates of lacking a usual source of care remained stable across all 4 race/ethnicity subgroups up to 2009, while rates of foregone/delayed medical care due to cost increased. Between 2010 and 2015, the percentage of uninsured diminished for all, with the steepest reduction among Hispanics (−2.1% per year). In the same period, rates of no usual source of care declined only among Hispanics (−1.2% per year) while rates of foregone/delayed medical care due to cost decreased for all. No substantial changes were observed from 2016–2018 in any outcome across subgroups. Compared with 1999, in 2018 the rates of foregone/delayed medical care due to cost were higher for all (+3.1% among Whites, +3.1% among Blacks, +0.5% among Asians, and +2.2% among Hispanics) without significant change in gaps; rates of no usual source of care were not significantly different among Whites or Blacks but were lower among Hispanics (−4.9%) and Asians (−6.4%).Conclusions and RelevanceInsurance coverage increased for all, but millions of individuals remained uninsured or underinsured with increasing rates of unmet medical needs due to cost. Those identifying as non-Hispanic Black and Hispanic continue to experience more barriers to health care services compared with non-Hispanic White individuals.KEY POINTSQuestionIn the last 2 decades, what has been achieved in reducing barriers to access to care and race/ethnicity-associated disparities?FindingsUsing National Health Interview Survey data from 1999–2018, we found that insurance coverage increased across all 4 major race/ethnicity groups. However, rates of unmet medical needs due to cost increased without reducing the respective racial/ethnic disparities, and little-to-no change occurred in rates of individuals who have no usual source of care.MeaningDespite increased coverage, millions of Americans continued to experience barriers to access to care, which were disproportionately more prevalent among those identifying as Black or Hispanic.

scholarly journals When a Usual Source of Care and Usual Provider Matter: Adult Prevention and Screening Services

2008 ◽  
Vol 23 (9) ◽  
pp. 1354-1360 ◽  
Author(s):  
Lynn A. Blewett ◽  
Pamela Jo Johnson ◽  
Brian Lee ◽  
Peter B. Scal
Keyword(s):  
Usual Source Of Care ◽  
Usual Source ◽  
Source Of Care ◽  
Screening Services
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