Objective: Disparities in access to primary health care have led to health disadvantages among Latinos and other non-White racial groups. To better identify and understand which policies are most likely to improve health care for Latinos, we examined differences in access to primary care between Latinos with proficient English language skills and Latinos with limited English proficiency (LEP) and estimated the extent of access to primary care providers (PCPs) among Latinos in the U.S. Method: We used agent-based modeling techniques to estimate the effects of English proficiency, insurance coverage, Latinos with LEP seeking care from English-speaking PCPs, distance to PCP, PCP availability, and Spanish-speaking PCP availability on access to primary care. We used NetLogo 6.0 to simulate a community of 10,000 Latinos seeking care for a 6-month period, running 5 controlled experiments to determine if population-level outcomes varied by scenario. Results: Models suggested that Latinos with LEP would likely delay care less often if policies were implemented to expand health insurance coverage, address linguistic barriers and promote an inclusive health care climate for patients with LEP, reduce mobility barriers, increase the number of PCPs, and train more Spanish-speaking PCPs. Conclusions: Findings support results from prior studies suggesting that policies and programs that help Latino patients overcome linguistic and cultural barriers to health care will improve Latinos’ access to care.

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解决美国拉丁裔人获得初级保健的障碍：基于代理的模型

目标：获得初级卫生保健的差距导致拉丁美洲人和其他非白人种族群体的健康不利。为了更好地识别和了解哪些政策最有可能改善拉丁裔美国人的医疗保健，我们研究了英语水平熟练的拉丁裔美国人和英语能力有限的拉丁裔美国人在获得初级保健方面的差异，并估计了获得初级保健的程度美国的拉丁美洲人中的医疗服务提供者（PCP）方法：我们使用基于代理的建模技​​术来估计英语水平，保险范围，拉丁裔与LEP寻求英语PCP的护理，与PCP的距离，PCP可用性以及西班牙语-在获得初级保健方面，PCP的可用性。我们使用NetLogo 6.0模拟了一个由10,000名拉丁裔组成的社区，他们在6个月内寻求护理，进行5项对照实验，以确定人群水平的结果是否因情景而异。结果：模型表明，如果实施政策来扩大健康保险覆盖范围，解决语言障碍并促进LEP患者的包容性医疗保健氛围，减少流动障碍，增加PCP的数量，则患有LEP的拉丁裔可能会较少地延迟护理培训更多讲西班牙语的PCP。结论：发现支持先前研究的结果，表明帮助拉丁裔患者克服医疗保健的语言和文化障碍的政策和计划将改善拉丁裔获得护理的机会。模型表明，如果实施政策来扩大健康保险覆盖范围，解决语言障碍并促进LEP患者的包容性医疗保健氛围，减少行动障碍，增加PCP数量并进行更多培训，则患有LEP的拉丁裔可能会较少地延迟护理讲西班牙语的PCP。结论：发现支持先前研究的结果，表明帮助拉丁裔患者克服医疗保健的语言和文化障碍的政策和计划将改善拉丁裔获得护理的机会。模型表明，如果实施政策来扩大健康保险覆盖范围，解决语言障碍并促进LEP患者的包容性医疗保健氛围，减少行动障碍，增加PCP数量并进行更多培训，则患有LEP的拉丁裔可能会较少地延迟护理讲西班牙语的PCP。结论：发现支持先前研究的结果，表明帮助拉丁裔患者克服医疗保健的语言和文化障碍的政策和计划将改善拉丁裔获得护理的机会。