Barriers to Care Among American Indians in Public Health Care Programs

Dados Bibliográficos

ID9099790
AutoresKathleen Thiede Call (0000-0003-2731-1573, University of Minnesota, autor correspondente), Donna D Mcalpine, Donna Mcalpine (0000-0002-1855-6272, University of Minnesota, autor correspondente), Pamela Jo Johnson (0000-0003-3034-1378, University of Minnesota, autor correspondente), Timothy J Beebe (0000-0003-4700-2436, Mayo Clinic), James A Mcrae (Minnesota Department of Human Services), Yunjie Song, Xue Song (0000-0002-9305-9161, University of Minnesota, autor correspondente)
Ano2006
Volume44
Fascículo6
Páginas595-600
Data de publicação2006-06-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000215901.37144.94
PMID16708009
OpenAlexW2040778855
IdiomaEN
Citações recebidas39
Referências citadas10

OBJECTIVE: We sought to examine the extent to which reported barriers to health care services differ between American Indians (AIs) and non-Hispanic Whites (Whites). METHODS: A statewide stratified random sample of Minnesota health care program enrollees was surveyed. Responses from AI and White adult enrollees (n=1281) and parents of child enrollees (n=572) were analyzed using logistic regression models that account for the complex sample design. Barriers examined include: financial, access, and cultural barriers, confidence/trust in providers, and discrimination. RESULTS: Both AIs and Whites report barriers to health care access. However, a greater proportion of AIs report barriers in most categories. Among adults, AIs are more likely to report racial discrimination, cultural misunderstandings, family/work responsibilities, and transportation difficulties, whereas Whites are more likely to report being unable to see their preferred doctor. A higher proportion of adult enrollees compared with parents of child enrollees report barriers in most categories; however, differences between parents of AIs and White children are more substantial. In addition to racial discrimination and cultural misunderstandings, parents of AI children are more likely than parents of White enrollees to report limited clinic hours, lack of respect for religious beliefs, and mistrust of their child's provider as barriers. CONCLUSIONS: Although individuals have enrolled in health care programs and have access to care, barriers to using these services remain. Significant differences between AIs and Whites involve issues of trust, respect, and discrimination. Providers must address barriers experienced by AIs to improve accessibility, acceptability, and quality of care for AI health care consumers

African american · Ethnic group · Family medicine · Health care · Health equity · Logistic regression · Political science · Public health · Cultural Competency in Health Care · Medicine · Migration, Health and Trauma · Nursing · Racial and Ethnic Identity Research · Gerontology