4.4 Article

Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer

Journal

MEDICAL CARE
Volume 59, Issue 6, Pages 528-536

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MLR.0000000000001538

Keywords

cancer; Asian Americans; access to care; health care spending; financial burden

Funding

  1. TUFCCC/HC Regional Comprehensive Cancer Health Disparity Partnership
  2. National Cancer Institute [U54 CA221704 (5)]
  3. National Institute of Aging [R56AG062315]
  4. National Institute on Minority Health and Health Disparities [R01MD011523]

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The study found that Asian Americans without cancer experienced limited access to care due to a lack of a usual source of care. However, inequities were not observed among Asian Americans with cancer. Additionally, there were no or marginal differences in health care spending between Whites and Asian Americans with cancer.
Background: Asian Americans have lower cancer screening rates than non-Latino Whites, suggesting inequities in cancer prevention among Asian Americans. Little is known about inequities in cancer treatment between Whites and Asian Americans with cancer. Methods: Using the 2002-2017 Medical Expenditure Panel Survey, we examined inequities in access to care and health care spending between Whites and Asian Americans with and without cancer. Our outcomes included 3 measures of access to care and 3 measures of health care spending. We used multivariable regressions while adjusting for predisposing, enabling, and need factors and estimated the mean adjusted values of the outcomes for each group. We then examined the differences in these adjusted mean outcomes among Asian Americans relative to Whites. Results: We observed evidence of inequities that Asian Americans without cancer experienced limited access to care due to a lack of a usual source of care. The likelihood of having a usual source of care was lower among Asian Americans without cancer than Whites without cancer. Inequities were not observed among Asian Americans with cancer. Compared with Whites with cancer, Asian Americans with cancer had similar or better levels of access to care. No or marginal differences in health care spending were detected between Whites and Asian Americans with cancer. These findings were consistent in both nonelderly and elderly groups. Conclusion: While Asian Americans without cancer have unmet medical needs due to limited access to care, access to care and spending are relatively equitable between Whites and Asian Americans with cancer.

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