The Affordable Care Act was implemented with the aim of increasing coverage and affordable access with hopes of improving health outcomes and reducing costs. Yet, disparities persist. Coverage and affordable access alone cannot explain the health care gap between racial/ethnic minorities and white patients. Instead, the focus has turned to other factors affecting utilization rates such as the patient-provider relationship. Data from nationally represented U.S. households in 2009–2017 were used to study the association between patient-provider social distance as measured by “racial/ethnic concordance” and health care utilization rates for periods covering pre- and post-ACA. Despite the reduction in financial barriers to health access with the implementation of the ACA, the correlation between racial/ethnic concordance and utilization remains positive and significant. The results suggest that while the ACA may have improved coverage and affordability, other dimensions of access, particularly acceptability, as measured by patient-provider clinical interaction experience, remains a factor in the decision to utilize care.

《平价医疗法案》的实施旨在扩大覆盖范围和负担得起的医疗服务，以期改善健康结果并降低成本。然而，差距依然存在。仅凭覆盖面和负担得起的获取并不能解释种族/少数民族与白人患者之间的医疗保健差距。相反，重点已转向影响使用率的其他因素，例如患者与提供者的关系。2009-2017 年来自全国代表的美国家庭的数据用于研究以“种族/民族一致性”衡量的患者-提供者社会距离与 ACA 前后时期的医疗保健利用率之间的关联。尽管随着 ACA 的实施减少了获得医疗保健的财务障碍，种族/族裔一致性与利用之间的相关性仍然是积极的和显着的。结果表明，虽然 ACA 可能提高了覆盖率和可负担性，但其他方面的可及性，特别是可接受性，根据患者与提供者的临床互动经验衡量，仍然是决定使用护理的一个因素。