Overall and Avoidable Healthcare Utilization among Heterogeneous Hispanic/Latino Ethnic Groups with Cognitive Impairment in the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA)

拉丁裔认知障碍异质性西班牙裔/拉丁裔族群的总体和可避免医疗保健利用情况:拉丁裔神经认知老化研究 (SOL-INCA)

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Abstract

BACKGROUND: Latino individuals represent one of the fastest-growing demographic groups in the United States, and the impact of dementia is rising within this population. Despite this growth, most research on healthcare utilization has predominantly focused on non-Hispanic White populations. The limited body of literature that does include Latino populations often treats them as a monolithic racial/ethnic category, which overlooks intra-group heterogeneity. As a result, little is known about how healthcare utilization patterns relate to cognitive impairment status across specific Latino ethnic groups. METHODS: Using data collected from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA), we examined the odds of overall healthcare utilization and avoidable healthcare utilization according to cognitive impairment and whether these associations vary by Latino ethnicity. Weighted logistic regressions and two-way interactions were conducted. RESULTS: This study included 4,825 (unweighted) Latino participants (1,664 Mexican, 917 Cuban, 859 Puerto Rican, 437 Dominican, 481 Central American, 345 South American, and 142 More than One/Other). Overall, participants reported high rates of overall healthcare utilization (88%) and avoidable healthcare utilization (42%). Individuals with cognitive impairment had higher odds of both overall (OR = 1.94, p = 0.013) and avoidable healthcare utilization (OR = 1.51, p = 0.004) compared to those without cognitive impairment. Puerto Rican participants were the only ethnic group found to have significant differences in avoidable healthcare utilization and cognitive impairment (OR = 2.61, p = 0.014). DISCUSSION: Disaggregation of Latino data revealed significant healthcare utilization across Latino ethnic groups. Targeted interventions and resources are needed to promote preventive care that may decrease avoidable healthcare utilization and associated expenditures.

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