Access to Care Among Hispanics: Implications for Understanding Community Variation

Do rates of access to health care differ between Hispanics and non-Hispanics, and if so, how much of that difference can be accounted for by the measurement tools used? Researchers at Project HOPE examined how access to health care differs between Hispanic and non-Hispanic populations, as well as between sub-groups within the Hispanic population. They developed a measure of access based on the use of services relative to health status. This approach was designed to be less dependent on respondent perceptions than traditional approaches. In addition, they analyzed variation in access across communities, for both Hispanics and non-Hispanics, comparing the results using this newly-developed measurement method, and those using existing measurement tools such as number of physician visits, hospitalizations, and inability to obtain care. The analysis was done using hierarchical modeling of data from the Community Tracking Study Household Survey, which served to reduce random variation across communities and allowed researchers to draw more credible inferences about the role of community and personal characteristics relative to access. Finally, they linked the Tracking data to data from the U.S. Census in order to examine characteristics that may affect access to care in communities where Hispanics live. The objective of this study was to not only understand access issues faced by Hispanics, but to better understand the extent to which apparent differences in access, obtained by traditional measurement methods, are a result of measurement technique as opposed to actual difficulties faced by the populations.