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Does Access to Care Still Affect Health Care Utilization by Immigrants? Testing of an Empirical Explanatory Model of Health Care Utilization by Korean American Immigrants with High Blood Pressure

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Abstract

Despite well-known benefits of health care utilization for the effective management of chronic diseases, the underlying mechanism of understanding health care utilization in ethnic minority population has not been systematically explored. The purpose of this paper is to examine the predictive ability of a health care utilization model by analyzing the interplay between predisposing, enabling, and need factors. The sample consisted of hypertensive Korean American immigrants (KAIs) 40–64 years of age who participated in a self-help intervention for high blood pressure care (SHIP-HBP). Using structured questionnaires, data were collected from 445 KAIs at baseline and analyzed with path analysis. Insurance status and relevant medical history were not just strong direct effects but also carried the most total effect on the health care utilization of these patients. Life priorities, years of residence in the US and perceived income level exerted indirect effects through the participants’ insurance status. Our statistical analysis indicated a good fit for the proposed model (x 2 = 28.4, P = 0.29; NFI = 0.91; CFI = 0.99; RMSEA = 0.02). Overall, the model explained 18% of the variance in health care utilization of hypertensive KAIs. These findings strongly support a need to improve access to health care for KAIs by introducing a variety of community resources and building sustainable community infrastructures.

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Authors and Affiliations

  1. Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe St, Baltimore, MD, 21205-2179, USA

    Hee-Jung Song

  2. Department of Health Systems and Outcomes, School of Nursing, Johns Hopkins University, 525 N. Wolfe St, Baltimore, MD, 21205-2179, USA

    Hae-Ra Han, Jong-Eun Lee & Ji-Yun Kim

  3. Korean Resource Center, 3201 Rogers Ave, Suite 203, Ellicott City, MD, 21043, USA

    Kim B. Kim

  4. Department of Sociology, Loyola College in Maryland, 4501 N. Charles Street, Baltimore, MD, 21210, USA

    Jai Poong Ryu

  5. Department of Health Systems and Outcomes, School of Nursing, Johns Hopkins University, 525 N. Wolfe St, Room 432, Baltimore, MD, 21205-2179, USA

    Miyong Kim

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  1. Hee-Jung Song
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  2. Hae-Ra Han
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  3. Jong-Eun Lee
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Correspondence to Hee-Jung Song.

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Song, HJ., Han, HR., Lee, JE. et al. Does Access to Care Still Affect Health Care Utilization by Immigrants? Testing of an Empirical Explanatory Model of Health Care Utilization by Korean American Immigrants with High Blood Pressure. J Immigrant Minority Health 12, 513–519 (2010). https://doi.org/10.1007/s10903-009-9276-1

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  • DOI: https://doi.org/10.1007/s10903-009-9276-1

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