Mueller KJ, Patil K, et al. The role of uninsurance and race in healthcare utilization by rural minorities. Health Services Research. 1998;33:597-610.
The purpose of this study was to examine the independent effects of minority status, residence, insurance status, and income on physician use, controlling for general health status and the presence of acute or chronic health problems. Using data from the 1992 Health Interview Study, the researchers performed statistical techniques to detect independent effects of residence and minority status on whether individuals used physician services. They found the most important determinant of health services to be insurance status, regardless of race/ethnicity or place of residence (rural or urban). Other findings from this study included: 1) racial and ethnic minorities were less likely than were whites to use physician services, and rural residents' use of physician services was generally lower than that of urban residents; 2) except for Latinos, rural residence lowered the likelihood that the uninsured saw a physician in the previous 12 months; 3) insured rural residents surpassed urban residents in accessing physicians; 4) rural Asian and African Americans were the least likely to have used physician services; 5) there are regional differences across the United States in the likelihood of seeing a physician; 6) rural Latinos have the most limited access to physician services, which is best addressed through economic development policies that include adequate insurance coverage; and 7) ensuring the cultural appropriateness of programs and policies is important for improving appropriate use of health care among rural minorities.
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