Barriers to Care in an Ethnically Diverse Publicly Insured Population

Is Health Care Reform Enough

Datos Bibliográficos

ID9102423
AutoresKathleen Thiede Call (0000-0003-2731-1573, University of Minnesota System, autor de correspondencia), Donna D Mcalpine, Donna Mcalpine (0000-0002-1855-6272, Twin Cities Orthopedics, autor de correspondencia), Carolyn M Garcia, Carolyn Garcia (University of Minnesota), Nathan D Shippee (0000-0002-9885-3663, Twin Cities Orthopedics, autor de correspondencia), Nathan Shippee, Timothy J Beebe (0000-0003-4700-2436, Mayo Clinic), Timothy Beebe, Titilope Cole Adeniyi, Titilope Adeniyi (Twin Cities Orthopedics, autor de correspondencia), Tetyana Shippee (0000-0003-1804-2527, Twin Cities Orthopedics, autor de correspondencia)
Año2014
Volumen52
Número8
Páginas720-727
Fecha de publicación2014-08-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000172
PMID25023917
OpenAlexW1834909852
IdiomaEN
Citas recibidas16
Referencias citadas10

BACKGROUND: The Affordable Care Act provides for the expansion of Medicaid, which may result in as many as 16 million people gaining health insurance coverage. Yet it is unclear to what extent this coverage expansion will meaningfully increase access to health care. OBJECTIVE: The objective of the study was to identify barriers that may persist even after individuals are moved to insurance and to explore racial/ethnic variation in problems accessing health care services. RESEARCH DESIGN: Data are from a 2008 cross-sectional mixed-mode survey (mail with telephone follow-up in 4 languages), which is unique in measuring a comprehensive set of barriers and in focusing on several select understudied ethnic groups. We examine racial/ethnic variation in cost and coverage, access, and provider-related barriers. The study adhered to a community-based participatory research process. SUBJECTS: Surveys were obtained from a stratified random sample of adults enrolled in Minnesota Health Care Programs who self-report ethnicity as white, African American, American Indian, Hispanic, Hmong, or Somali (n=1731). RESULTS: All enrollees reported barriers to getting needed care; enrollees from minority cultural groups (Hmong and American Indian in particular) were more likely to experience problems than whites. Barriers associated with cost and coverage were the most prevalent, with 72% of enrollees reporting 1 or more of these problems. Approximately 63% of enrollees reported 1 or more access barriers. Provider-related barriers were the least prevalent (about 29%) yet revealed the most pervasive disparities. CONCLUSIONS: Many challenges to care persist for publicly insured adults, particularly minority racial and ethnic groups. The ACA expansion of Medicaid, although necessary, is not sufficient for achieving improved and equitable access to care

Environmental health · Ethnic group · Family medicine · Health care · Health equity · Medicaid · Political science · Population · Public health · Somali · Food Security and Health in Diverse Populations · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology