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Differences in use of high- and low-value health care between immigrant and US-born adults
Journal article   Open access   Peer reviewed

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

Sungchul Park, Arturo Vargas Bustamante, Jie Chen and Alexander N Ortega
Health services research
24 Jul 2023
DOI: https://doi.org/10.1111/1475-6773.14206
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10480075View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

OBJECTIVETo 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.

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4 citations in Web of Science
3 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Health Care Sciences & Services
Health Policy & Services
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