Diverging Racial and Ethnic Disparities in Access to Physician Care

Department of Economics, Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA.
Medical care (Impact Factor: 3.23). 02/2012; 50(4):327-34. DOI: 10.1097/MLR.0b013e318245a111
Source: PubMed


To examine recent changes in racial and ethnic disparities in access to physician services in the United States, and investigate the economic factors driving the changes observed.
Using nationally representative data on adults aged 25-64 from the 2000 and 2007 Medical Expenditure Panel Survey, we examine changes in two measures of access: whether the individual reported having a usual source of care, and whether he/she had any doctor visits during the past year. In each year, we calculate disparities in access between African Americans and Whites, and between Hispanics and Whites, applying the Institute of Medicine's definition of a disparity. Nonlinear regression decomposition techniques are then used to quantify how changes in personal characteristics, comparing 2000 and 2007, helped shape the changes observed.
Large disparities in access to physician care were evident for both minority groups in 2000 and 2007. Disparities in no doctor visits during the past year diminished for African Americans, but disparities in both measures worsened sharply for Hispanics.
Disparities in access to physician care are improving for African Americans in one dimension, but eroding for Hispanics in multiple dimensions. The most important contributing factors to the growing disparities between Hispanics and Whites are health insurance, education, and income differences.

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    • "Andersen (1995) proposed a framework of access to health care in which access is determined by environment including health care system and external environment, population characteristics which include predisposing characteristics such as demographic factors, community and personal enabling resources such as income and health insurance, and health needs which consist of both perceived and evaluated health status including the presence of comorbidity and disability [4]. Empirical studies have demonstrated that race/ethnicity, health insurance status, income, and demographic characteristics including health status are important contributing factors to access disparities [5,6]. "
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