Health Care Access and Utilization Among US-Born and Foreign-Born Asian Americans

Ye, Jiali; Mack, Dominic; Fry-Johnson, Yvonne; Parker, Katrina

doi:10.1007/s10903-011-9543-9

Cited by 64 publications

(49 citation statements)

References 26 publications

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“…For age category (pooled and disaggregated data), the odds of having an ED visit were less than one among older-aged Asians compared to their younger counterparts (ages 18-24). This is consistent with previous research that reported younger adults were more likely to receive care in an ED compared to adults who were older (Fortuna, Robbins, Mani, & Halterman, 2010;Uscher-Pines, Pines, Kellermann, Gillen, & Mehrotra, 2013;Ye et al, 2012). This may also be partly explained by higher ED utilization rates for drug poisoning among persons aged 20-34 years (Albert et al, 2015).…”

Section: Background Factorssupporting

confidence: 90%

“…We made comparisons between subgroups using socio-demographic characteristics and other model factors. This was deemed important, as differences have been noted in socioeconomic status, years living in the United States, and access/utilization of health care services among distinct Asian ethnic groups (Ye et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Reports indicate that among Asian ethnic subgroups, Filipinos and Chinese represent the largest proportion of Asians in the United States (Hoeffel, Rastogi, Kim & Shahid, 2012). While the immigration of Asians to the United States has continued over generations, differences have been noted in health care utilization by immigration status and between Asian ethnic subgroups (Ye, Mack, Fry-Johnson, & Parker, 2012).…”

Section: Emergency Department Utilization Among Asians In the United mentioning

confidence: 99%

“…This may coincide with the other Asian subgroup also having the lowest frequency of being covered by insurance. Ye et al (2012) noted that among Asians, those who were foreign-born were significantly less likely to have health insurance. However, there was not an association between reports of an ED visit and geographic regions where larger populations of Asians reside.…”

Section: Background Factorsmentioning

confidence: 99%

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Emergency department use among Asian adults living in the United States: Results from the National Health Interview Survey (2006 – 2013)

Sullivan¹,

Davis²,

Sy³

2017

Asian/Pacific Island Nursing Journal

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This paper presents secondary analyses of the National Health Interview Survey data focused on emergency department (ED) utilization among Asian adults residing in the United States. National Health Interview Survey data provided from survey years 2006-2013 was pooled and disaggregated by single-race Asian ethnic subgroups (Filipino, Chinese, Asian Indian, other Asian). We explored trends in reports of an ED visit over the survey years for the purpose of determining whether reports of an ED visit increased or decreased over survey years. We also explored background/biologic, environment, access to care, and behavior factors and their associations with having an ED visit. The majority of respondents were foreign-born (75.9%) and had lived in the United States for ten or more years (54.3%). Estimates for reports of any ED visits ranged from 8.3% for the Chinese to 15.3% for the Filipino subgroups. Filipinos were more likely to have an ED visit compared to the Chinese and other Asians (except Asian Indians). For the eight years of survey data, estimates indicate a trend of fewer reports of any ED visit among the Asian Indian and Filipino subgroups. Among Filipinos, having diabetes and a smoking history were associated with an ED visit. The odds of an ED visit were higher among Asians in the youngest age category, among other Asians born in the United States, and among those who saw/talked to a mental health professional within the previous year. As there is a paucity of information available about ED use among Asians or Asian subgroups, this report adds to the literature on patterns of health care utilization among Asian subgroups living in the United States with a specific focus on ED utilization.

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Section: Background Factorssupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Emergency Department Utilization Among Asians In the United mentioning

confidence: 99%

Section: Background Factorsmentioning

confidence: 99%

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Emergency department use among Asian adults living in the United States: Results from the National Health Interview Survey (2006 – 2013)

Sullivan¹,

Davis²,

Sy³

2017

Asian/Pacific Island Nursing Journal

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“…1 Evidence has demonstrated the cultural and language barriers to healthcare access among people with Asian origins. 2 Asian Americans are characterized with diverse ethnic groups with unique cultural values and traditions. It is estimated that approximately 76.9% of Asian Americans speak a language other than English in their home and that 35.5% have limited English proficiency.…”

Section: Introductionmentioning

confidence: 99%

Telepsychiatry Services for Korean Immigrants

Shim

Lukaszewski

et al. 2012

Telemedicine and e-Health

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Asian Americans often face cultural and language barriers when obtaining mental health treatment. With the small number of Asian mental health providers, it is difficult to ensure the linguistic and ethnic matching of providers and patients. Telepsychiatry holds great promise to address the unique needs of Asian Americans. We developed a project to establish telepsychiatry services that connect Korean mental health patients in Georgia with a linguistically and culturally competent psychiatrist in California and assessed the level of acceptability of psychiatric treatment via real-time teleconferencing among these patients. Upon the completion of the program, 16 patients (5 men, 11 women) completed a questionnaire that measured their acceptability of the telepsychiatry service. The findings indicate a high level of acceptance of the program among Korean patients. The quantitative and qualitative data show that they especially appreciated the cultural sensitivity of the consultation and the comfortable interaction with the provider. However, challenges such as technical issues of teleconferencing may negatively affect the quality of the clinical interaction. Our study expands the knowledge base regarding the acceptability of such services to a population that experiences disparities in mental health care. Future research should extend telepsychiatry services to other Asian population groups that experience lower access to mental health services.

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Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke

Song

Fonarow

et al. 2019

JAMA Neurol

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IMPORTANCE Although overall stroke incidence and mortality in the United States is improving, little is known about the characteristics and clinical outcomes of acute ischemic stroke in Asian American individuals.OBJECTIVE To compare the characteristics, care, and outcomes of Asian American and white patients with acute ischemic stroke. DESIGN, SETTING, PARTICIPANTS Retrospective analysis of Asian American and white patients admitted with a primary diagnosis of acute ischemic stroke to hospitals participating in the Get With The Guidelines-Stroke (GWTG-Stroke) program between April 1, 2004, and July 31, 2016. The GWTG-Stroke database is a prospectively collected stroke quality improvement registry sponsored by the American Heart Association/American Stroke Association. MAIN OUTCOMES AND MEASURESMultivariable logistic regression models assessed the association of Asian American race/ethnicity, clinical outcomes, and quality measures. RESULTSThe study population of 1 772 299 patients (mean [SD] age, 72.4 [14.2] years; 51.3% female) consisted of 64 337 Asian American patients (3.6%) and 1 707 962 white patients (96.4%) admitted to 2171 GWTG-Stroke hospitals with acute ischemic stroke. After adjustment for patient and hospital variables, Asian American patients were seen with greater stroke severity compared with white patients (National Institutes of Health Stroke Scale [NIHSS] score Ն16) (odds ratio [OR], 1.35; 95% CI, 1.30-1.40; P < .001), manifested higher in-hospital mortality (OR, 1.14; 95% CI, 1.09-1.19; P < .001), had longer length of stay (OR, 1.17; 95% CI, 1.14-1.20; P < .001), and were less likely to ambulate independently at discharge (OR, 0.84; 95% CI, 0.79-0.90; P < .001). Although Asian American patients had fewer intravenous tissue plasminogen activator (IV tPA) administrations than white patients (OR, 0.95; 95% CI, 0.91-0.98; P = .003), they had more symptomatic hemorrhage after tPA (OR, 1.36; 95% CI, 1.20-1.55; P < .001) and overall post-tPA complications (OR, 1.31; 95% CI, 1.18-1.46; P < .001). Asian American patients had better quality measure adherence overall than white patients, including rehabilitation (OR, 1.27; 95% CI, 1.18-1.36; P < .001), door to tPA within 60 minutes (OR, 1.14; 95% CI, 1.06-1.22; P < .001), and intensive statin therapy (OR, 1.14; 95% CI, 1.10-1.18; P < .001). After adjustment for stroke severity, Asian American patients had lower in-hospital mortality than white patients (OR, 0.95; 95% CI, 0.91-0.99; P = .008). CONCLUSIONS AND RELEVANCEAsian American patients manifested more severe ischemic strokes, were less likely to receive IV tPA, and had worse functional outcomes than white patients. These findings warrant additional research toward improving clinical outcomes for Asian American patients with acute ischemic stroke.

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Health Care Access and Utilization Among US-Born and Foreign-Born Asian Americans

Cited by 64 publications

References 26 publications

Emergency department use among Asian adults living in the United States: Results from the National Health Interview Survey (2006 – 2013)

Emergency department use among Asian adults living in the United States: Results from the National Health Interview Survey (2006 – 2013)

Telepsychiatry Services for Korean Immigrants

Comparison of Clinical Care and In-Hospital Outcomes of Asian American and White Patients With Acute Ischemic Stroke

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