Access to Primary and Preventive Care among Foreign-Born Adults in Canada and the United States

被引:50
作者
Lebrun, Lydie A. [1 ]
Dubay, Lisa C. [1 ]
机构
[1] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD 21205 USA
基金
加拿大健康研究院; 美国医疗保健研究与质量局;
关键词
Access to health care; primary care; immigrants; Canada; United States; HEALTH-CARE; CHINESE IMMIGRANTS; PAP-SMEAR; WOMEN; DISPARITIES; INSURANCE; SERVICES; VALIDATION; CHALLENGES; DEPRESSION;
D O I
10.1111/j.1475-6773.2010.01163.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective To conduct cross-country comparisons and assess the effect of foreign birth on access to primary and preventive care in Canada and the United States. Data Sources Secondary data from the 2002 to 2003 Joint Canada-United States Survey of Health. Study Design Descriptive and comparative analyses were conducted, and logistic regression models were used to assess the effect of immigrant status and country of residence on access to care. Outcomes included measures of health care systems and processes, utilization, and patient perceptions. Principal Findings In adjusted analyses, immigrants in Canada fared worse than nonimmigrants regarding having timely Pap tests; in the United States, immigrants fared worse for having a regular doctor and an annual consultation with a health professional. Immigrants in Canada had better access to care than immigrants in the United States; most of these differences were explained by differences in socioeconomic status and insurance coverage across the two countries. However, U.S. immigrants were more likely to have timely Pap tests than Canadian immigrants, even after adjusting for potential confounders. Conclusions In both countries, foreign-born populations had worse access to care than their native-born counterparts for some indicators but not others. However, few differences in access to care were found when direct cross-country comparisons were made between immigrants in Canada versus the United States, after accounting for sociodemographic differences.
引用
收藏
页码:1693 / 1719
页数:27
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