Examining the Role of Healthcare Access in Racial/Ethnic Disparities in Receipt of Provider-patient
Friday, May 21, 2021
Posted by: Natalia Gromov
Li
L, Zhan S, Hu L, Wilson KM, Mazumdar M, Liu B.
Examining the Role of
Healthcare Access in Racial/Ethnic Disparities in Receipt of Provider-patient
Discussions about Smoking: A Latent Class Analysis.
Prev Med. 2021 Apr 27;148:106584. doi: 10.1016/j.ypmed.2021.106584. Epub ahead
of print. PMID: 33930432.
Using insurance as a single indicator of healthcare access in examining the
association between race/ethnicity and healthcare encounter-based interventions
for smoking may not be adequate. In this study, we assessed the role of
healthcare access using multifactorial measures in accounting for racial/ethnic
disparities in the receipt of provider-patient discussions, defined as either
being asked about smoking or advised to quit smoking by providers. We
identified adult current smokers from the 2015 National Health Interview
Survey. We first conducted a latent class analysis (LCA) to identify the
underlying patterns of healthcare access measured by 13 indicators of
healthcare access and utilization. We then used a propensity score - based
weighting approach to examine racial/ethnic disparities in receiving
provider-patient discussions about smoking or quitting in stratified groups by
the distinct healthcare access clusters. Out of the 4134 adult current smokers
who visited a doctor or a healthcare provider during the past 12 months, 3265
(79.90%) participants were classified as having high healthcare access and 869
(20.10%) participants as having low healthcare access. Compared to non-Hispanic
whites, Hispanics had significantly lower odds of being asked about smoking (OR
0.46, 95% CI (0.27-0.77)) and being advised to quit (OR 0.57, 95% CI
(0.34-0.97)) in the low access group, but neither association was significant
in the high access group. In addition to increasing health insurance coverage,
reducing other healthcare access barriers for Hispanics will likely facilitate
provider-patient discussion and promote tobacco cessation among Hispanic
smokers.
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