Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act
Bibliographic Data
| ID | 9102084 |
|---|---|
| Authors | Jie Chen (0000-0002-9254-4413, University of Maryland, College Park, corresponding author), Arturo Vargas Bustamante (0000-0003-0414-5015, University of California, Los Angeles), Arturo Vargas-Bustamante, Karoline Mortensen (0000-0002-9549-7288, University of Miami), Alexander N Ortega (0000-0001-6861-6993, Drexel University) |
| Year | 2016 |
| Volume | 54 |
| Issue | 2 |
| Pages | 140-146 |
| Publication date | 2016-02-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000467 |
| PMID | 26595227 |
| OpenAlex | W2176321678 |
| Language | EN |
| Citations received | 111 |
| References cited | 10 |
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
Emergency department · Environmental health · Ethnic group · Health care · Health equity · Health insurance · Multivariate analysis · Patient Protection and Affordable Care Act · Political science · Population · Public health · Demography · Emergency and Acute Care Studies · Healthcare Policy and Management · Internal Medicine · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology
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| Unique citing works | 111 |
|---|---|
| Citations per year | 11,1 |
| Citation span | 2016 - 2026 (11) |
| Citation velocity | current |
| Highly cited | Yes |
| Citation types | Neutral: 111 |