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- W3167560613 abstract "To determine whether the relationship between perceived discrimination (PD) and cost-related non-utilization (CRNU) of healthcare services can be explained by Andersen’s predisposing, need, and enabling factors. The available evidence does not describe the explanatory roles of demographic, health, and financial factors, which limits our understanding of PD and CRNU. We conducted a retrospective cross-sectional study using the 2014 Behavioral Risk Factor Surveillance System dataset, a state-based survey of US adults aged 18 and older. We utilized the most recent data on five “Reactions to Race” (R2R) items that measured PD. Binary CRNU outcomes were: 1) did not visit a physician due to cost (CRNU_visit); 2) did not fill a prescription due to cost (CRNU_rx). We estimated model coefficients using sequential logistic regression models. The crude model (M0) included only the R2R variables. Subsequent models sequentially added predisposing (M1), need (M2), and enabling (M3) variables. We examined the percentage change in the Akaike Information Criterion (AIC) across models. The final sample included 18,707 respondents. The proportions for African Americans, Hispanics, and females were 9.3%, 13.6%, and 50.1%, respectively. The proportions for CRNU_visit and CRNU_rx were 14.1% and 8.9%, respectively. Across all models, R2R variables were positively associated with CRNU. The percentage reductions in the AIC for the CRNU models were: CRNU_visit: 4.8% (M1 vs. M0), 3.7% (M2 vs. M1), and 15.5% (M3 vs. M2); CRNU_rx: 3.3%, 6.8%, and 9.4%. The number of statistically significant R2R variables in the CRNU_visit models fell from 4 (M0; crude) to 2 (M3; fully adjusted). The number of statistically significant R2R variables in the CRNU_rx models fell from 5 (M0; crude) to 1 (M3; fully adjusted). Across sequential models of CRNU, model fit improved the most when enabling factors were included. Enabling factors partly explained the positive association between PD and CRNU." @default.
- W3167560613 created "2021-06-22" @default.
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- W3167560613 date "2021-06-01" @default.
- W3167560613 modified "2023-10-15" @default.
- W3167560613 title "PNS55 Perceived Discrimination and Cost-Related Non-Utilization of Healthcare Services: A Systematic Examination of Explanatory Factors" @default.
- W3167560613 doi "https://doi.org/10.1016/j.jval.2021.04.910" @default.
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