The Effects of the Affordable Care Act on Health Care Access and Utilization Among Asian American Subgroups.
Med Care
; 57(11): 861-868, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31634267
ABSTRACT
OBJECTIVES:
We examined changes in health care access and utilization associated with the Patient Protection and Affordable Care Act (ACA) for different Asian American subgroups relative to non-Latino whites (whites). RESEARCHDESIGN:
Using 2003-2017 California Health Interview Survey data, we examined changes in 4 health care access measures and 2 utilization measures among whites and 7 Asian American subgroups. We estimated the unadjusted and adjusted percentage point changes on the absolute scale from the pre-ACA to post-ACA periods. Adjusted estimates were obtained from multivariable logistic regression models that controlled for predisposing, enabling, and need factors. We also estimated the pre-ACA to post-ACA changes between whites and Asian American subgroups using a difference-in-difference approach.RESULTS:
After the ACA was implemented, uninsurance decreased among all Asian American subgroups, but improvements in disparities relative to whites in these measures were limited. In particular, Koreans had the largest absolute reduction in uninsurance (-16.8 percentage points) and were the only subgroup with a significant reduction in terms of disparities relative to whites (-10.1 percentage points). However, little or no improvement was observed in the other 3 access measures (having a usual source of care, delayed medical care in past year, or delayed prescription drug use in past year) and 2 utilization measures (having a physician visit or emergency department visit in past year).CONCLUSIONS:
Despite coverage gains among Asian American subgroups, especially Koreans, disparities in access and utilization persisted across all Asian American subgroups.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Asiático
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Aceitação pelo Paciente de Cuidados de Saúde
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Patient Protection and Affordable Care Act
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Utilização de Instalações e Serviços
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Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Evaluation_studies
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Observational_studies
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Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Med Care
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Panamá