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Barriers to Care in an Ethnically Diverse Publicly Insured Population

Is Health Care Reform Enough

Bibliographic Data

ID9102423
AuthorsKathleen Thiede Call (0000-0003-2731-1573, University of Minnesota System, corresponding author), Donna D Mcalpine, Donna Mcalpine (0000-0002-1855-6272, Twin Cities Orthopedics, corresponding author), Carolyn M Garcia, Carolyn Garcia (University of Minnesota), Nathan D Shippee (0000-0002-9885-3663, Twin Cities Orthopedics, corresponding author), Nathan Shippee, Timothy J Beebe (0000-0003-4700-2436, Mayo Clinic), Timothy Beebe, Titilope Cole Adeniyi, Titilope Adeniyi (Twin Cities Orthopedics, corresponding author), Tetyana Shippee (0000-0003-1804-2527, Twin Cities Orthopedics, corresponding author)
Year2014
Volume52
Issue8
Pages720-727
Publication date2014-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000172
PMID25023917
OpenAlexW1834909852
LanguageEN
Citations received16
References cited10

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

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Unique citing works16
Citations per year1,45
Citation span2015 - 2026 (12)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 16
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