The Association between Immigration Status and Office-based Medical Provider Visits for Cancer Patients in the United States

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. Methods: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups. We measured the relationships of immigrant status to number of visits and associated expenditure within the past 12 months, adjusting for age, sex, educational attainment, race/ethnicity, self-reported health status, time since cancer diagnosis, cancer remission status, marital status, poverty status, insurance status, and usual source of care. We finally performed sensitivity analyses for regression results by using the propensity score matching method to adjust for potential selection bias. Results: Noncitizens had about 2 fewer visits in a 12-month period in comparison to US-born citizens (4.0 vs. 5.9). Total expenditure per patient was higher for US-born citizens than immigrants (not statistically significant). Noncitizens (88.3%) were more likely than US-born citizens (76.6%) to be seen by a medical doctor during a visit. Multivariate regression results showed that noncitizens had 42% lower number of visiting medical providers at office-based settings for cancer care than US-born citizens, after adjusting for all the other covariates. There were no significant differences in expenditures across immigration groups. The propensity score matching results were largely consistent with those in multivariate-adjusted regressions. Conclusions: Results suggest targeted interventions are needed to reduce disparities in utilization between immigrants and US-born citizen cancer patients.

Original languageEnglish (US)
Pages (from-to)629-635
Number of pages7
JournalMedical Care
Volume55
Issue number6
DOIs
StatePublished - 2017

Fingerprint

Emigration and Immigration
Health Expenditures
Neoplasms
Propensity Score
Insurance Coverage
Selection Bias
Marital Status
Poverty
Health Surveys
Health Status
Regression Analysis
Demography
Interviews
Health

Keywords

  • health disparities
  • immigrant status
  • office-based medical provider visits

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{15f6e0ebe51e4b0793d30a75c46f0c48,
title = "The Association between Immigration Status and Office-based Medical Provider Visits for Cancer Patients in the United States",
abstract = "Objectives: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. Methods: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups. We measured the relationships of immigrant status to number of visits and associated expenditure within the past 12 months, adjusting for age, sex, educational attainment, race/ethnicity, self-reported health status, time since cancer diagnosis, cancer remission status, marital status, poverty status, insurance status, and usual source of care. We finally performed sensitivity analyses for regression results by using the propensity score matching method to adjust for potential selection bias. Results: Noncitizens had about 2 fewer visits in a 12-month period in comparison to US-born citizens (4.0 vs. 5.9). Total expenditure per patient was higher for US-born citizens than immigrants (not statistically significant). Noncitizens (88.3{\%}) were more likely than US-born citizens (76.6{\%}) to be seen by a medical doctor during a visit. Multivariate regression results showed that noncitizens had 42{\%} lower number of visiting medical providers at office-based settings for cancer care than US-born citizens, after adjusting for all the other covariates. There were no significant differences in expenditures across immigration groups. The propensity score matching results were largely consistent with those in multivariate-adjusted regressions. Conclusions: Results suggest targeted interventions are needed to reduce disparities in utilization between immigrants and US-born citizen cancer patients.",
keywords = "health disparities, immigrant status, office-based medical provider visits",
author = "Yang Wang and Fernando Wilson and Li-Wu Chen",
year = "2017",
doi = "10.1097/MLR.0000000000000697",
language = "English (US)",
volume = "55",
pages = "629--635",
journal = "Medical Care",
issn = "0025-7079",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - The Association between Immigration Status and Office-based Medical Provider Visits for Cancer Patients in the United States

AU - Wang, Yang

AU - Wilson, Fernando

AU - Chen, Li-Wu

PY - 2017

Y1 - 2017

N2 - Objectives: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. Methods: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups. We measured the relationships of immigrant status to number of visits and associated expenditure within the past 12 months, adjusting for age, sex, educational attainment, race/ethnicity, self-reported health status, time since cancer diagnosis, cancer remission status, marital status, poverty status, insurance status, and usual source of care. We finally performed sensitivity analyses for regression results by using the propensity score matching method to adjust for potential selection bias. Results: Noncitizens had about 2 fewer visits in a 12-month period in comparison to US-born citizens (4.0 vs. 5.9). Total expenditure per patient was higher for US-born citizens than immigrants (not statistically significant). Noncitizens (88.3%) were more likely than US-born citizens (76.6%) to be seen by a medical doctor during a visit. Multivariate regression results showed that noncitizens had 42% lower number of visiting medical providers at office-based settings for cancer care than US-born citizens, after adjusting for all the other covariates. There were no significant differences in expenditures across immigration groups. The propensity score matching results were largely consistent with those in multivariate-adjusted regressions. Conclusions: Results suggest targeted interventions are needed to reduce disparities in utilization between immigrants and US-born citizen cancer patients.

AB - Objectives: We examined differences in cancer-related office-based provider visits associated with immigration status in the United States. Methods: Data from the 2007-2012 Medical Expenditure Panel Survey and National Health Interview Survey included adult patients diagnosed with cancer. Univariate analyses described distributions of cancer-related office-based provider visits received, expenditures, visit characteristics, as well as demographic, socioeconomic, and health covariates, across immigration groups. We measured the relationships of immigrant status to number of visits and associated expenditure within the past 12 months, adjusting for age, sex, educational attainment, race/ethnicity, self-reported health status, time since cancer diagnosis, cancer remission status, marital status, poverty status, insurance status, and usual source of care. We finally performed sensitivity analyses for regression results by using the propensity score matching method to adjust for potential selection bias. Results: Noncitizens had about 2 fewer visits in a 12-month period in comparison to US-born citizens (4.0 vs. 5.9). Total expenditure per patient was higher for US-born citizens than immigrants (not statistically significant). Noncitizens (88.3%) were more likely than US-born citizens (76.6%) to be seen by a medical doctor during a visit. Multivariate regression results showed that noncitizens had 42% lower number of visiting medical providers at office-based settings for cancer care than US-born citizens, after adjusting for all the other covariates. There were no significant differences in expenditures across immigration groups. The propensity score matching results were largely consistent with those in multivariate-adjusted regressions. Conclusions: Results suggest targeted interventions are needed to reduce disparities in utilization between immigrants and US-born citizen cancer patients.

KW - health disparities

KW - immigrant status

KW - office-based medical provider visits

UR - http://www.scopus.com/inward/record.url?scp=85013361002&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013361002&partnerID=8YFLogxK

U2 - 10.1097/MLR.0000000000000697

DO - 10.1097/MLR.0000000000000697

M3 - Article

VL - 55

SP - 629

EP - 635

JO - Medical Care

JF - Medical Care

SN - 0025-7079

IS - 6

ER -