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Longitudinal changes in health servi...

Choi, Sunha.

Longitudinal changes in health service use among older foreign-born individuals.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Longitudinal changes in health service use among older foreign-born individuals./
Author:	Choi, Sunha.
Description:	169 p.
Notes:	Source: Dissertation Abstracts International, Volume: 68-06, Section: A, page: 2654.
Contained By:	Dissertation Abstracts International68-06A.
Subject:	Gerontology. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3268018
ISBN:	9780549070528

Longitudinal changes in health service use among older foreign-born individuals.
Choi, Sunha.

Longitudinal changes in health service use among older foreign-born individuals. - 169 p.

Source: Dissertation Abstracts International, Volume: 68-06, Section: A, page: 2654.

Thesis (Ph.D.)--Washington University in St. Louis, 2007.

Among older foreign-born individuals, the sign of systemic inaccessibility to health care is observed especially among nearly-arrived older immigrants. Inadequate health insurance has been found as a major structural barrier. Using three waves of data from the Second Longitudinal Study of Aging (1994-2000), this study compared longitudinal trajectories of health, insurance, and service use between three groups (age 70+): (1) late-life immigrants with less than 15 years of residence in US (recent immigrants; n=133); (2) older foreign-born individuals with 1.5 years or longer residence in US (earlier immigrants; n=672); and (3) the U.S.-born (n=8,642). Hierarchical Generalized Linear Modeling was used with the guidance of the Andersen model.

ISBN: 9780549070528Subjects--Topical Terms:

168436
Gerontology.

Longitudinal changes in health service use among older foreign-born individuals.
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245 1 0 $a Longitudinal changes in health service use among older foreign-born individuals.
300 $a 169 p.
500 $a Source: Dissertation Abstracts International, Volume: 68-06, Section: A, page: 2654.
500 $a Adviser: Nancy Morrow-Howell.
502 $a Thesis (Ph.D.)--Washington University in St. Louis, 2007.
520 $a Among older foreign-born individuals, the sign of systemic inaccessibility to health care is observed especially among nearly-arrived older immigrants. Inadequate health insurance has been found as a major structural barrier. Using three waves of data from the Second Longitudinal Study of Aging (1994-2000), this study compared longitudinal trajectories of health, insurance, and service use between three groups (age 70+): (1) late-life immigrants with less than 15 years of residence in US (recent immigrants; n=133); (2) older foreign-born individuals with 1.5 years or longer residence in US (earlier immigrants; n=672); and (3) the U.S.-born (n=8,642). Hierarchical Generalized Linear Modeling was used with the guidance of the Andersen model.
520 $a The results indicate that recent immigrants' health was more limited than that of their counterparts over time. In term of health insurance, recent immigrants displayed improvement over time with the increasing likelihood of having private insurance and decreasing likelihood of remaining uninsured. However, a disproportionately higher proportion of recent immigrants relied on Medicaid, while they were much less likely to have Medicare over time.
520 $a The probability of having a usual source of care increased steadily regardless of immigrant status. However, the findings indicate an indirect relationship between immigrant status and access to care through insurance status (i.e., mediating effect). This implies lower probabilities of having a usual source of care among recent immigrants through a lower level of Medicare/private insurance status compared to their counterparts. Among those who already had a usual source of care, higher levels of service use were observed among recent immigrants. Also, African Americans, Hispanics, and receiving Medicaid were related to higher levels of service use. Medicare and private insurance were not related.
520 $a Insurance status is an important factor related to newly-arrived older immigrants' health service use. Considering recent immigrants' unique insurance profile, further studies are necessary to compare the quality of health services and out-of-pocket expenditures by immigrant status. State and federal policies which try to limit health insurance benefits for immigrants arrived after the welfare reform of 1996 will make older immigrants more vulnerable in accessing health care.
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