TY - JOUR
T1 - The Association between Immigration Status and Office-based Medical Provider Visits for Cancer Patients in the United States
AU - Wang, Yang
AU - Wilson, Fernando A.
AU - Chen, Li Wu
PY - 2017
Y1 - 2017
N2 - Objectives: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. Methods: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups. We measured the relationships of immigrant status to number of visits and associated expenditure within the past 12 months, adjusting for age, sex, educational attainment, race/ethnicity, self-reported health status, time since cancer diagnosis, cancer remission status, marital status, poverty status, insurance status, and usual source of care. We finally performed sensitivity analyses for regression results by using the propensity score matching method to adjust for potential selection bias. Results: Noncitizens had about 2 fewer visits in a 12-month period in comparison to US-born citizens (4.0 vs. 5.9). Total expenditure per patient was higher for US-born citizens than immigrants (not statistically significant). Noncitizens (88.3%) were more likely than US-born citizens (76.6%) to be seen by a medical doctor during a visit. Multivariate regression results showed that noncitizens had 42% lower number of visiting medical providers at office-based settings for cancer care than US-born citizens, after adjusting for all the other covariates. There were no significant differences in expenditures across immigration groups. The propensity score matching results were largely consistent with those in multivariate-adjusted regressions. Conclusions: Results suggest targeted interventions are needed to reduce disparities in utilization between immigrants and US-born citizen cancer patients.
AB - Objectives: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. Methods: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups. We measured the relationships of immigrant status to number of visits and associated expenditure within the past 12 months, adjusting for age, sex, educational attainment, race/ethnicity, self-reported health status, time since cancer diagnosis, cancer remission status, marital status, poverty status, insurance status, and usual source of care. We finally performed sensitivity analyses for regression results by using the propensity score matching method to adjust for potential selection bias. Results: Noncitizens had about 2 fewer visits in a 12-month period in comparison to US-born citizens (4.0 vs. 5.9). Total expenditure per patient was higher for US-born citizens than immigrants (not statistically significant). Noncitizens (88.3%) were more likely than US-born citizens (76.6%) to be seen by a medical doctor during a visit. Multivariate regression results showed that noncitizens had 42% lower number of visiting medical providers at office-based settings for cancer care than US-born citizens, after adjusting for all the other covariates. There were no significant differences in expenditures across immigration groups. The propensity score matching results were largely consistent with those in multivariate-adjusted regressions. Conclusions: Results suggest targeted interventions are needed to reduce disparities in utilization between immigrants and US-born citizen cancer patients.
KW - health disparities
KW - immigrant status
KW - office-based medical provider visits
UR - http://www.scopus.com/inward/record.url?scp=85013361002&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85013361002&partnerID=8YFLogxK
U2 - 10.1097/MLR.0000000000000697
DO - 10.1097/MLR.0000000000000697
M3 - Article
C2 - 28221273
AN - SCOPUS:85013361002
SN - 0025-7079
VL - 55
SP - 629
EP - 635
JO - Medical Care
JF - Medical Care
IS - 6
ER -