This study examines the determinants of health services access among Chinese Americans using data from a three-stage strata-cluster survey conducted on 1,747 respondents after screening of 16,916 households in Los Angeles in 1993 and 1994.
A multinomial logit model examines the factors associated with three outcomes for usual source of care: private physicians, other providers, and none. Thirty-one percent of the sample were not insured. Respondents with insurance were much more likely to see a western-trained physician for health problems. The multinomial logit results show, in comparison to those with western-style private physicians as usual source of care, education significantly increased the probability of using other providers. Those scored high on interpersonal sensitivity were much more likely to choose other providers over private physicians. The insured were much less likely to have no usual source of care, so were those well acculturated. Alarmingly, those with depression or paranoia were much more likely to have no usual source of care. Only 1% of those who suffered from depression sought any service, whether from formal or informal providers.
The findings suggest that the perceived impersonal delivery of formal health care might have hindered access. Lacking insurance or suffering from mental illnesses also rendered one with poor or no access to care. Lastly, Chinese Americans with major depression were severely underserved. Therefore, universal health insurance and higher cultural competence among physicians could remove some barriers. The low number of depression patients who received any health services indicated a dire need for more outreach.
Learning Objectives: Obtain empirical evidence on the effect of key determinants such as insurance, health status, and acculaturation on the use of physical and mental health services among Chinese Americans. Discuss policy implications for delivering culturally competent services to a growing minority consumer population
Keywords: Health Care Utilization, Cultural Competency
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.