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Access to Care

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Access to medical care is worse for Asians and Pacific Islanders than for whites and other ethnic groups

A new study shows that Asians and Pacific Islanders on the West Coast had worse access to care than whites or any other ethnic group. This was surprising, since Asians had the highest proportion of high-income people and a larger proportion of well-educated individuals than other groups in the study, factors usually associated with better access to care.

Cultural differences and associated communication problems may better explain the access problems experienced by Asians. More studies are needed to understand why Asians are more likely to experience problems in accessing care than members of other ethnic/racial groups who experience similar barriers to care, note researchers from the University of California, Los Angeles, and RAND. The study was supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant HS00046).

The researchers surveyed demographics and access to care of Asians and Pacific Islanders and other ethnic and racial groups receiving managed health care from 48 physician groups in California and five other States (Washington, Oregon, Texas, Arizona, and New Jersey). They defined access to care as preventive services, time-related access for routine care or general needs, telephone access, specialty services, and general access. With the exception of two preventive service measures, Asians had the worst access scores and scored their plans as needing improvement more often than any other group on amount of time waiting for service approval (85 percent vs. 67 percent for whites), waiting time before appointments with specialists (85 percent vs. 74 percent for whites), and ability to obtain treatment when needed (72 percent vs. 55 percent of whites).

Asians and Pacific Islanders were consistently the largest group giving their health plan a very poor/poor or fair rating for ease of getting staff by phone, ease of scheduling appointments by phone, access to a specialist when needed, ease of getting laboratory tests or radiology exams ordered by the primary care physician, and ease of getting a referral for mental health care. Whites had the best access to care followed by Native Americans, others, blacks, Hispanics, and finally, Asians and Pacific Islanders. Better translation services and training of providers in cultural sensitivity may reduce cultural and communication barriers to care for Asians, conclude the authors.

For more details, see "Access to medical care reported by Asians and Pacific Islanders in a West Coast physician group association," by Rani E. Snyder, William Cunningham, Terry T. Nakazono, and Ron D. Hays in the June 2000 Medical Care Research and Review 57(2), pp. 196-215.

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