The relation between health insurance and health care disparities among adults with disabilities
We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES). We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We mo...
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| Veröffentlicht in: | American journal of public health (1971) 2014-03, Vol.104 (3), p.e85-e93 |
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| container_title | American journal of public health (1971) |
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| creator | Miller, Nancy A Kirk, Adele Kaiser, Michael J Glos, Lukas |
| description | We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES).
We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors. We then included health insurance and examined the extent to which it reduced observed differences by race, ethnicity, and SES.
We found evidence of disparities in access and use among adults with disabilities. Adjusting for health insurance reduced these disparities most consistently for emergency department use. Uninsured individuals experienced substantially poorer access across most measures, including reporting a usual source of care and experiencing delays in or being unable to obtain care.
Although health insurance is an important enabling resource among adults with disabilities, its effect on reducing differences by race, ethnicity, and SES on health care access and use was limited. Research exploring the effects of factors such as patient-provider interactions is warranted. |
| doi_str_mv | 10.2105/AJPH.2013.301478 |
| format | Article |
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We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors. We then included health insurance and examined the extent to which it reduced observed differences by race, ethnicity, and SES.
We found evidence of disparities in access and use among adults with disabilities. Adjusting for health insurance reduced these disparities most consistently for emergency department use. Uninsured individuals experienced substantially poorer access across most measures, including reporting a usual source of care and experiencing delays in or being unable to obtain care.
Although health insurance is an important enabling resource among adults with disabilities, its effect on reducing differences by race, ethnicity, and SES on health care access and use was limited. Research exploring the effects of factors such as patient-provider interactions is warranted.</description><identifier>ISSN: 0090-0036</identifier><identifier>ISSN: 1541-0048</identifier><identifier>EISSN: 1541-0048</identifier><identifier>DOI: 10.2105/AJPH.2013.301478</identifier><identifier>PMID: 24328621</identifier><identifier>CODEN: AJPHDS</identifier><language>eng</language><publisher>United States: American Public Health Association</publisher><subject><![CDATA[Adolescent ; Adult ; Age ; Black or African American ; Black People - statistics & numerical data ; Confidence Intervals ; Dental care ; Disability ; Disabled Persons - statistics & numerical data ; Educational attainment ; Emergency medical care ; Ethnicity ; Expenditures ; Female ; Handicapped accessibility ; Health care access ; Health care policy ; Health Care Surveys ; Health insurance ; Health Policy ; Health Services Accessibility ; Healthcare Disparities ; Hispanic Americans ; Hispanic or Latino - statistics & numerical data ; Humans ; Insurance coverage ; Insurance Coverage - statistics & numerical data ; Insurance, Health ; Male ; Marital status ; Medicaid ; Medicare ; Middle Aged ; Minority & ethnic groups ; Online Research and Practice ; People with disabilities ; Population ; Prescription drugs ; Public health ; Race ; Race/Ethnicity ; Self report ; Socioeconomic Factors ; Studies ; Uninsured people ; United States ; Variables ; White People - statistics & numerical data ; Young Adult]]></subject><ispartof>American journal of public health (1971), 2014-03, Vol.104 (3), p.e85-e93</ispartof><rights>Copyright American Public Health Association Mar 2014</rights><rights>American Public Health Association 2014 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-188f67c8d61c7748e808763d2a1b76b3bd91c695803475e57a9bec31b9a514853</citedby><cites>FETCH-LOGICAL-c424t-188f67c8d61c7748e808763d2a1b76b3bd91c695803475e57a9bec31b9a514853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953783/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953783/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24328621$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miller, Nancy A</creatorcontrib><creatorcontrib>Kirk, Adele</creatorcontrib><creatorcontrib>Kaiser, Michael J</creatorcontrib><creatorcontrib>Glos, Lukas</creatorcontrib><title>The relation between health insurance and health care disparities among adults with disabilities</title><title>American journal of public health (1971)</title><addtitle>Am J Public Health</addtitle><description>We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES).
We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors. We then included health insurance and examined the extent to which it reduced observed differences by race, ethnicity, and SES.
We found evidence of disparities in access and use among adults with disabilities. Adjusting for health insurance reduced these disparities most consistently for emergency department use. Uninsured individuals experienced substantially poorer access across most measures, including reporting a usual source of care and experiencing delays in or being unable to obtain care.
Although health insurance is an important enabling resource among adults with disabilities, its effect on reducing differences by race, ethnicity, and SES on health care access and use was limited. Research exploring the effects of factors such as patient-provider interactions is warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Black or African American</subject><subject>Black People - statistics & numerical data</subject><subject>Confidence Intervals</subject><subject>Dental care</subject><subject>Disability</subject><subject>Disabled Persons - statistics & numerical data</subject><subject>Educational attainment</subject><subject>Emergency medical care</subject><subject>Ethnicity</subject><subject>Expenditures</subject><subject>Female</subject><subject>Handicapped accessibility</subject><subject>Health care access</subject><subject>Health care policy</subject><subject>Health Care Surveys</subject><subject>Health insurance</subject><subject>Health Policy</subject><subject>Health Services Accessibility</subject><subject>Healthcare Disparities</subject><subject>Hispanic Americans</subject><subject>Hispanic or Latino - statistics & numerical data</subject><subject>Humans</subject><subject>Insurance coverage</subject><subject>Insurance Coverage - statistics & numerical data</subject><subject>Insurance, Health</subject><subject>Male</subject><subject>Marital status</subject><subject>Medicaid</subject><subject>Medicare</subject><subject>Middle Aged</subject><subject>Minority & ethnic groups</subject><subject>Online Research and Practice</subject><subject>People with disabilities</subject><subject>Population</subject><subject>Prescription drugs</subject><subject>Public health</subject><subject>Race</subject><subject>Race/Ethnicity</subject><subject>Self report</subject><subject>Socioeconomic Factors</subject><subject>Studies</subject><subject>Uninsured people</subject><subject>United States</subject><subject>Variables</subject><subject>White People - statistics & numerical data</subject><subject>Young 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relation between health insurance and health care disparities among adults with disabilities</title><author>Miller, Nancy A ; Kirk, Adele ; Kaiser, Michael J ; Glos, Lukas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-188f67c8d61c7748e808763d2a1b76b3bd91c695803475e57a9bec31b9a514853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Black or African American</topic><topic>Black People - statistics & numerical data</topic><topic>Confidence Intervals</topic><topic>Dental care</topic><topic>Disability</topic><topic>Disabled Persons - statistics & numerical data</topic><topic>Educational attainment</topic><topic>Emergency medical care</topic><topic>Ethnicity</topic><topic>Expenditures</topic><topic>Female</topic><topic>Handicapped accessibility</topic><topic>Health care access</topic><topic>Health care 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Health</addtitle><date>2014-03</date><risdate>2014</risdate><volume>104</volume><issue>3</issue><spage>e85</spage><epage>e93</epage><pages>e85-e93</pages><issn>0090-0036</issn><issn>1541-0048</issn><eissn>1541-0048</eissn><coden>AJPHDS</coden><abstract>We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES).
We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors. We then included health insurance and examined the extent to which it reduced observed differences by race, ethnicity, and SES.
We found evidence of disparities in access and use among adults with disabilities. Adjusting for health insurance reduced these disparities most consistently for emergency department use. Uninsured individuals experienced substantially poorer access across most measures, including reporting a usual source of care and experiencing delays in or being unable to obtain care.
Although health insurance is an important enabling resource among adults with disabilities, its effect on reducing differences by race, ethnicity, and SES on health care access and use was limited. Research exploring the effects of factors such as patient-provider interactions is warranted.</abstract><cop>United States</cop><pub>American Public Health Association</pub><pmid>24328621</pmid><doi>10.2105/AJPH.2013.301478</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; PAIS Index; EBSCOhost Education Source; Business Source Complete; PubMed Central; Alma/SFX Local Collection |
| subjects | Adolescent Adult Age Black or African American Black People - statistics & numerical data Confidence Intervals Dental care Disability Disabled Persons - statistics & numerical data Educational attainment Emergency medical care Ethnicity Expenditures Female Handicapped accessibility Health care access Health care policy Health Care Surveys Health insurance Health Policy Health Services Accessibility Healthcare Disparities Hispanic Americans Hispanic or Latino - statistics & numerical data Humans Insurance coverage Insurance Coverage - statistics & numerical data Insurance, Health Male Marital status Medicaid Medicare Middle Aged Minority & ethnic groups Online Research and Practice People with disabilities Population Prescription drugs Public health Race Race/Ethnicity Self report Socioeconomic Factors Studies Uninsured people United States Variables White People - statistics & numerical data Young Adult |
| title | The relation between health insurance and health care disparities among adults with disabilities |
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