The purpose of this study is to describe the perceived differences in availability and quality of health care among Hispanics with chronic obstructive pulmonary disease (COPD) in comparison to other racial groups.
Responses to self-reported perception of health care availability and quality from participants in the 1999 Veterans Health Administration Large Health Survey who had at least 1 visit with an ICD-9 code for COPD were analyzed for variations among races. Subjects without a reported smoking history were excluded, leaving 89,485 individuals in the analysis.
Eighty-seven percent (77,495) of participants categorized themselves as “white,” 9.1% (8,139) as “black,” and 2.7% (2,413) as “Hispanic.” The remaining percentage of the cross-section was comprised of a variety of racial groups. Hispanics reported fewer cardiac comorbidities (congestive heart failure, angina, myocardial infarction) but more psychiatric comorbidities (depression, post-traumatic stress disorder, schizophrenia) than the whites or blacks. A greater number of Hispanics did not have a regular doctor (12%) and also did not know the next step in their care plan (22.9%) compared to whites, 9% and 18.8%, respectively. Eleven percent of Hispanics reported problems receiving care compared to only 8% of whites, and 9% of blacks. More Hispanics had problems obtaining referrals to a specialist, and also rated the overall quality of care they received in the previous 2 months as “poor” or “very poor” more frequently (5.5%) than the white (3.7%) or black (3.4%) respondents.CONCLUSIONS: Hispanics appeared to have less participation in their care plan compared to other racial groups, and despite the entitlement of equal health care among VA beneficiaries, Hispanics perceived decreased availability and poorer quality of care compared to other races.
This disparity in the perception of the availability and quality of care in Hispanics with COPD requires further study to identify whether this group is indeed receiving less optimal care or whether psychiatric illness or cultural differences impact on their perception of care received.
A.C. Hospenthal, None.