Trust in physicians, health insurance, and health care utilization among Chinese older immigrants. Issue 1 (2nd January 2023)

• Record Type: Journal Article
• Authors: Cao, Qiuchang (Katy); Krok-Schoen, Jessica L.; Guo, Man; Dong, XinQi
• Is Part Of: Ethnicity & health. Volume 28:Issue 1(2023)
• Page Start: 78
• Page End: 95
• Publication Date: 2023-01-02
• Subjects: Chinese older immigrants -- trust in physicians -- health care utilization -- health insurance -- moderation analysis; Ethnic groups -- Health and hygiene -- Periodicals; Ethnic groups -- Medical care -- Periodicals; Medical care -- Cross-cultural studies -- Periodicals; Ethnic Groups -- periodicals; Delivery of Health Care -- periodicals; Social Sciences -- periodicals; 362.1089
• DOI: 10.1080/13557858.2022.2027881
• Languages: English
• ISSNs: 1355-7858

Abstract

Abstract : Objective: Trust in physicians (TIP) plays a critical role in the health care utilization (HCU) of minority older adults and older immigrants. Although previous studies suggested that TIP was positively associated with primary care visits, negatively associated with Emergency Room (ER) visits and hospitalization among African Americans in the United States (U.S.), it is unclear whether and how TIP influences various types of HCU among Chinese older immigrants, a fast-growing group of minority older immigrants in the U.S. Furthermore, despite the important role insurance plays in HCU and health disparities, few studies have tested whether TIP influences the HCU of the insured and uninsured Chinese older immigrants differently. Therefore, this study aims to examine the role of TIP in three types of HCU (physician visits, ER visits, and hospitalization) among Chinese older immigrants and whether the associations differ by insurance status. Design: The data were derived from the P opulation Study of ChIN ese E lderly in Chicago (PINE), N = 3, 157. The sample is representative of Chinese older immigrants (60+ years) in Chicago. Guided by Andersen's behavioral model, hierarchical regression analyses examined the role of TIP in physician visits, ER visits, and hospitalization among Chinese older immigrants. An interaction term was added to examine whether the aforementioned associations differed by insurance status. Results: TIP was positively associated with the likelihood of physician visits (Odds Ratio [ OR ] = 1.07, p < 0.001) but not with ER ( OR = 1.02, p = 0.054) or hospitalization ( OR = 1.01, p = 0.13). The results of the moderation analyses further showed that TIP was more positively associated with ER visits ( OR =0.94, p =0.006) and hospitalization ( OR = 0.93, p = 0.004) among the uninsured population, compared to those insured. Conclusions: TIP played an important role in facilitating primary care visits among Chinese older immigrants regardless of insurance status. Additionally, TIP facilitated the ER visit and hospitalization among uninsured Chinese older immigrants.