Understanding Pathways to Usual Source of Care among Asian Americans.

Abstract

Although the prevailing conceptual model for health care access is the Andersen Behavioral Model of Health Service Use, researchers have not evaluated empirically whether model pathways are appropriate for Asian Americans (AAs). Using path analysis with 2009 California Health Interview Survey data, we tested pathways among predisposing, enabling, and need factors and acculturation factors for having a usual source ofcare (USC) among AA adults. Pathway differences among ethnic subgroups (Chinese, Koreans, and Vietnamese) were also examined. The model adequately predicted USC among AAs. As expected, insurance was the key predictor but higher education levels were associated with lower income and lower income with having a USC. English proficiency also contributed significantly to the AA model. Ethnic subgroup models varied significantly. Findings suggest that the Andersen behavioral model is appropriate for studying USC among AAs though pathways vary by ethnicity. Pathways for education and English proficiency must be better understood.