The 130th Annual Meeting of APHA

Abstract #48512

Alberto Coustasse, MD, MBA, MPH, Department of Social Behavioral Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107-2699, 817-735-0150, coustasse@hotmail.com, Samuel T. Coleridge, DO, Texas College of Medicine, Department of Family Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107-2699, Fernando Trevino, PhD, MPH, Health Management and Policy, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, and Manuel Bayona, MD, PhD, Department of Epidemiology, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107-2699.

This cross-sectional study compares the health care services utilization rates by type of health insurance of patients receving emergency and inpatient hospitalization services in a teaching Osteopathic hospital in Texas during the year 1998. Race/ethnicity and insurance status data was obtained from the hospital database. Statistically significant differences by race/ethnicity were observed regarding the insurance status and type of insurance. In ER, White non Hispanics differed significantly (p<0.0001) in the use of managed care coverage (37.4%) compared to Hispanics (24.4%) and African Americans (27.2%). They also had the highest use of Medicare (19.5%) in comparison with Hispanics (9.3%; p<0.0001) and African Americans (18.4%; p=0.1398). Hispanics patients showed the highest use of self pay (42.2%) when compared with White non Hispanics (26.8%; p<0.0001) and African Americans (26.5%; p<0.0001). Regarding inpatient services, Hispanics used more frequently Medicaid (40.4%) and selfpay (10.4%) than White non Hispanics (12.6%; p<0.0001 and 4.0%; p<0.0001, respectively), and African Americans (30.4%; p<0.0001 and 7.2%; p=0.0092, respectively). Compared with White non-Hispanics and African Americans, Hispanics demonstrated the lowest utilization of Medicare and the highest utilization of self-pay in the ER. Hispanics utilized the Medicaid program and self-pay most often for inpatient hospitalizations. Both Hispanics and African Americans showed less inpatient utilization than White non-Hispanics counterparts. These findings may suggest that Hispanics have less access to private insurance and Medicare than White non-Hispanics. This may represent a poor population without access to regular health care providers who may use the ER as their first or primary source of health care.

Learning Objectives:

• To describe limitations in health care access in the Hispanic community.
• To evaluate the health care utilization of the Emergency Room and inpatient services considering insurance type and race/ethnicity.

Keywords: Access to Health Care, Insurance

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: OHST/consultant