Differences in use of high‐ and low‐value health care between immigrant and US‐born adults

Author:

Park Sungchul12ORCID,Vargas Bustamante Arturo34,Chen Jie5,Ortega Alexander N.6ORCID

Affiliation:

1. Department of Health Policy and Management, College of Health Science Korea University Seoul Republic of Korea

2. BK21 FOUR R&E Center for Learning Health Systems Korea University Seoul Republic of Korea

3. Department of Health Policy and Management, Fielding School of Public Health, UCLA UCLA Los Angeles California USA

4. Latino Policy and Politics Institute UCLA Los Angeles California USA

5. Department of Health Policy and Management, School of Public Health University of Maryland College Park Maryland USA

6. Department of Health Management and Policy, Dornsife School of Public Health Drexel University Philadelphia Pennsylvania USA

Abstract

AbstractObjectiveTo examine differences in the use of high‐ and low‐value health care between immigrant and US‐born adults.Data SourceThe 2007–2019 Medical Expenditure Panel Survey.Study DesignWe split the sample into younger (ages 18–64 years) and older adults (ages 65 years and over). Our outcome measures included the use of high‐value care (eight services) and low‐value care (seven services). Our key independent variable was immigration status. For each outcome, we ran regressions with and without individual‐level characteristics.Data Collection/Extraction MethodsN/A.Principal FindingsBefore accounting for individual‐level characteristics, the use of high‐ and low‐value care was lower among immigrant adults than US‐born adults. After accounting for individual‐level characteristics, this difference decreased in both groups of younger and older adults. For high‐value care, significant differences were observed in five services and the direction of the differences was mixed. The use of breast cancer screening was lower among immigrant than US‐born younger and older adults (−5.7 [95% CI: −7.4 to −3.9] and −2.9 percentage points [95% CI: −5.6 to −0.2]) while the use of colorectal cancer screening was higher among immigrant than US‐born younger and older adults (2.6 [95% CI: 0.5 to 4.8] and 3.6 [95% CI: 0.2 to 7.0] percentage points). For low‐value care, we did not identify significant differences except for antibiotics for acute upper respiratory infection among younger adults and opioids for back pain among older adults (−3.5 [95% CI: −5.5 to −1.5] and −3.8[95% CI: −7.3 to −0.2] percentage points). Particularly, differences in socioeconomic status, health insurance, and care access between immigrant and US‐born adults played a key role in accounting for differences in the use of high‐ and low‐value health care. The use of high‐value care among immigrant and US‐born adults increased over time, but the use of low‐value care did not decrease.ConclusionDifferential use of high‐ and low‐value care between immigrant and US‐born adults may be partly attributable to differences in individual‐level characteristics, especially socioeconomic status, health insurance, and access to care.

Publisher

Wiley

Subject

Health Policy

Reference44 articles.

1. Immigrants And Health Care: Sources Of Vulnerability

2. Health Policy Challenges Posed By Shifting Demographics And Health Trends Among Immigrants To The United States

3. CamarotaSA ZeiglerK.Immigrant population hits record 46.2 million in november2021.2021https://cis.org/Camarota/Immigrant-Population-Hits-Record-462-Million-November-2021

4. BudimanA.Key findings about U.S. immigrants.2020https://www.pewresearch.org/fact‐tank/2020/08/20/key‐findings‐about‐u‐s‐immigrants/

5. Review: Immigrants and Health Care Access, Quality, and Cost

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