Abstract:
OBJECTIVE:This study examines whether parents' reports and ratings of pediatric health care vary by race/ethnicity and language in Medicaid managed care. DATA SOURCES:The data analyzed are from the National Consumer Assessment of Health Plans (CAHPS) Benchmarking Database 1.0 and consist of 9,540 children enrolled in Medicaid managed care plans in Arkansas, Kansas, Minnesota, Oklahoma, Vermont, and Washington state from 1997 to 1998. DATA COLLECTION:The data were collected by telephone and mail, and surveys were administered in Spanish and English. The mean response rate for all plans was 42.1 percent. STUDY DESIGN:Data were analyzed using multiple regression models. The dependent variables are CAHPS 1.0 ratings (personal doctor, specialist, health care, health plan) and reports of care (getting needed care, timeliness of care, provider communication, staff helpfulness, plan service). The independent variables are race/ethnicity (white, African American, American Indian, Asian, and Hispanic), Hispanic language (English or Spanish), and Asian language (English or other), controlling for gender, age, education, and health status. PRINCIPAL FINDINGS:Racial/ethnic minorities had worse reports of care than whites. Among Hispanics and Asians language barriers had a larger negative effect on reports of care than race/ethnicity. For example, while Asian non-English-speakers had lower scores than whites for staff helpfulness (beta = -20.10), timeliness of care (beta = -18.65), provider communication (beta = -17.19), plan service (beta = -10.95), and getting needed care (beta = -8.11), Asian English speakers did not differ significantly from whites on any of the reports of care. However, lower reports of care for racial/ethnic groups did not translate necessarily into lower ratings of care. CONCLUSIONS:Health plans need to pay increased attention to racial/ethnic differences in assessments of care. This study's finding that language barriers are largely responsible for racial/ethnic disparities in care suggests that linguistically appropriate health care services are needed to address these gaps.
journal_name
Health Serv Resjournal_title
Health services researchauthors
Weech-Maldonado R,Morales LS,Spritzer K,Elliott M,Hays RDkeywords:
subject
Has Abstractpub_date
2001-07-01 00:00:00pages
575-94issue
3eissn
0017-9124issn
1475-6773journal_volume
36pub_type
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1111/j.1475-6773.2006.00646.x
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更新日期:1985-06-01 00:00:00
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journal_title:Health services research
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doi:
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journal_title:Health services research
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doi:
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2013-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-08-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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更新日期:2005-10-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:1987-02-01 00:00:00
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doi:
更新日期:1980-01-01 00:00:00
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更新日期:2020-12-01 00:00:00
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更新日期:2004-10-01 00:00:00
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