Does Low-Value Care Explain Health Care Utilization Inequities Among Asian and Latino Populations?

초록

ObjectivesTo examine differences in the utilization of low-value care among Asian and Latino subpopulations compared to the White population.Study Setting and DesignWe analyzed data from a repeated cross-sectional national survey.Data Sources and Analytical SampleOur sample included a non-Latino White population and Asian and Latino subpopulation groups using data from the 2013-2021 Medical Expenditure Panel Survey.Principal FindingsAsian and Latino subpopulations used health care services less frequently than the White population, with adjusted differences ranging from -3.2% points (95% CI: -3.9, -2.4) to -9.4 (-10.1, -8.7) for outpatient visits, -5.2 (-5.9, -4.5) to -12.4 (-15.2, -9.6) for office-based provider visits, and -5.2 (-6.7, -3.8) to -19.1 (-21.6, -16.7) for prescription drug fills. Although certain low-value services were reported less among Asian and Latino subpopulations, there were no differences in almost six out of twelve services when compared to the White population. These patterns were notable among Asian subpopulations (Indians, Chinese, Filipinos, and other Asians). Additionally, Asian and Latino subpopulation groups had distinct patterns in the use of low-value care. Compared to the White population, Asian subpopulation groups had lower utilization of low-value medications including benzodiazepines for depression (-11.5 [-15.1, -8.0] to -13.8 [-24.4, -3.3]) and opioids for back pain (-4.4 [-8.5, -0.3] to -10.1 [-13.6, -6.7]). Latino subpopulation groups had higher utilization of low-value cervical cancer screening (5.7 [3.0-8.4] to 24.5 [16.9-32.1]) and lower utilization of magnetic resonance imaging/computed tomography for back pain (-1.6 [-2.4, -0.8] to -4.9 [-7.1, -2.6]) than the White population.ConclusionsDespite lower overall health care utilization, Asian and Latino subpopulations do not necessarily use the low-value care examined in this study less than the White population. This suggests that lower overall health care utilization among Asian and Latino subpopulations may not solely be attributed to lower use of low-value care.

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