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Health Care Utilization and Access among Immigrants and U.S. Born Citizens: Implications from the California Health Interview Survey

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https://ir.library.oregonstate.edu/concern/graduate_projects/nv935457j

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  • The objective of this study is to identify the variation in health care access and utilization among immigrant and U.S. born citizens in California. It aims at finding the reasons behind the disparity so that U.S. health agencies can make more efforts to improve the availability of health care services to immigrants. As an important determinant of health care utilization, the insurance coverage variable is also considered as a type of health care access. It is examined closely to see its relationship with other variables among immigrants. In this essay, Andersen’s Behavioral Model of Health Services Utilization (BHMSU) is used as the theoretical framework. The data are from the 2011-2012 California Health Interview Survey. There are 5,311 naturalized immigrants and 31,801 U.S. born citizens in the available sample. Chi-square tests and student t-tests are applied to detect significant differences in values of explanatory variables between the two groups. A negative binomial model of number of doctor visits and a logistic regression model of insurance coverage are then used to analyze the variation of health care utilization and health care access among immigrants. This study shows that immigrants are less likely to visit doctors after accounting for other variables, which means that immigrants’ health care utilization is significantly lower than for U.S. born citizens. Determinants for health care utilization are gender, health insurance coverage, income level, race and age. As for health care access, the insurance coverage variable is used as a measurement. As indicated from the study, lengthy duration of residence in the U.S. does not affect the probability of immigrants’ insurance coverage. However, language proficiency is a significant factor in predicting whether immigrants are insured as are socio-economic variables such as gender, race, income, age and marital status. Results indicate that naturalized citizens need greater access to health care and that insurance is a key variable in obtaining health care. This implies that immigrants can particularly benefit from the Affordable Care Act. The results also indicate that language translation services would be beneficial. Further research is needed to explore other aspects of health care access and utilization and to examine the current procedures of medical services. It also calls for evaluations of impacts of government programs including the Affordable Care Act on the insurance coverage and health care utilization of immigrants.
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