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Randomized Controlled Trial
. 2009 Nov;24 Suppl 3(Suppl 3):555-60.
doi: 10.1007/s11606-009-1080-z.

Effects of health insurance on perceived quality of care among Latinos in the United States

Debra Perez  1 , Alfonso Ang, William A Vega
Affiliations
Randomized Controlled Trial

Effects of health insurance on perceived quality of care among Latinos in the United States

Debra Perez et al. J Gen Intern Med. 2009 Nov.

Abstract

Background: There is suggestive evidence that lower rates of health insurance coverage increases the gaps in quality and access to care among Latinos as compared with non-Latino whites. In order to examine these potential disparities, we assessed the effects of insurance coverage and multiple covariates on perceived quality of care.

Objective: To assess the distribution of perceived quality of care received in a national Latino population sample, and the role of insurance in different patient subgroups.

Design: Telephone interviews conducted between 2007 and 2008 using the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Surveys (Waves 1 and 2).

Participants: Randomly selected Latino adults aged >or=18 years living in the United States.

Measurements: Pearson chi(2) tests identified associations among various demographic variables by quality of care ratings (poor, fair, good, excellent) for the insured and uninsured (Wave 1: N = 3545). Subgroup analyses were conducted among Wave 2 participants reporting chronic conditions (N = 1067). Bivariate and multivariate analyses were conducted to estimate the effects of insurance, demographic variables and consumer characteristics on quality of care.

Results: Insurance availability had an odds ratio of 1.47 (95% CI, 1.22-1.76) net of confounders in predicting perceived quality of care among Latinos. The largest gap in rates of excellent/good ratings occurred among the insured with eight or more doctor visits compared to the uninsured (76.2% vs. 54.6%, P < .05).

Conclusions: Future research can gain additional insights by examining the impact of health insurance on processes of care with a refined focus on specific transactions between consumers and providers' support staff and physicians guided by the principles of patient-centered care.

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Figures

Figure 1
Figure 1
Quality of care received, by insurance status**.
Figure 2
Figure 2
Health insurance coverage, by number of doctor visits*.
See this image and copyright information in PMC

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