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Factors Associated With Having a Usual Source of Care in an Ethnically Diverse Sample of Asian American Adults

Chang, Eva PhD, MPH*; Chan, Kitty S. PhD*; Han, Hae-Ra PhD, MSN, FAAN

doi: 10.1097/MLR.0000000000000187
Original Articles

Background: Despite significant population increases, how Asian Americans ethnic subgroups vary in having a usual source of care (USC) is poorly understood.

Objectives: To examine how having a USC varies among Asian American ethnic subgroups (Chinese, Filipinos, Japanese, Koreans, Vietnamese, and South Asians), and the potential factors influencing variation in having a USC.

Research Design: Data were from 2005 and 2009 California Health Interview Survey. Logistic regressions and pair-wise comparisons were used to compare odds of having a USC among Asian ethnic adults (18–64 y) and to examine ethnicity-specific associations with immigration-related factors (English proficiency, length of residence, and living in an ethnically concordant neighborhood) and key enabling (employment, income, insurance), predisposing (education), and need (health status) factors. Models also adjusted for other sociodemographic factors.

Results: Significant differences in the magnitude of the variation and factors influencing having a USC were found across Asian subgroups. Korean and Japanese adults had 52%–69% lower adjusted odds of having a USC compared with Chinese. Among all Asian subgroups, uninsured adults had 85%–94% lower adjusted odds of having a USC. Patterns of associations with USC and key factors varied by specific Asian subgroup.

Conclusions: Patterns of associations for USC varied by Asian subgroup, although uninsurance persisted significantly across all subgroups. Persistent variation and heterogenous associations suggest that targeted, ethnicity-specific policies and outreach are needed to improve having a USC for Asian American ethnic adults.

*Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health

Department of Community-Public Health, Johns Hopkins School of Nursing, Baltimore, MD

Funding for this work was provided by the Agency for Healthcare Research and Quality (R36 HS021684-01). The authors thank the University of California, Los Angeles, Center for Health Policy Research for providing access to the California Health Interview Survey confidential data.

The findings in this article were presented at the 2014 AcademyHealth Annual Research Meeting, San Diego, CA.

The authors declare no conflict of interest.

Reprints: Eva Chang, PhD, MPH, Group Health Cooperative, Group Health Research Institute, 1730 Minor Ave, Ste 1600, Seattle, WA 98101. E-mail: chang.eva@ghc.org.

© 2014 by Lippincott Williams & Wilkins.