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Racial disparities in health care utilization, the affordable care act and racial concordance preference

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Abstract

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.

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Notes

  1. Medicaid is a jointly funded program by U.S. states and the federal government to provide health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.

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  1. Alyson Ma and Alison Sanchez contributed equally to this work.

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  1. Department of Economics, University of San Diego School of Business, 5998 Alcala Park, San Diego, CA, 92110, USA

    Alyson Ma & Alison Sanchez

  2. Department of Psychology and Neuroscience, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL, 33314, USA

    Mindy Ma

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Ma, A., Sanchez, A. & Ma, M. Racial disparities in health care utilization, the affordable care act and racial concordance preference. Int J Health Econ Manag. 22, 91–110 (2022). https://doi.org/10.1007/s10754-021-09311-8

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