TABLE 4—
Adjusted Logistic Regression Models of 4 Access Measures by Insurance-Based Discrimination, Controlling for Respondents’ Characteristics and Health Status: 2013 Minnesota Health Access Survey
| Characteristic | Lack of a Usual Source of Care, OR (95% CI) | Lack of Confidence in Getting Needed Care, OR (95% CI) | Any Forgone Care Because of Cost, OR (95% CI) | Any Provider-Level Barriers, OR (95% CI) |
| Insurance-based discrimination | ||||
| Yes | 1.79* (1.09, 2.95) | 2.79** (1.44, 5.39) | 4.68*** (3.02, 7.24) | 2.63*** (1.62, 4.25) |
| No (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Insurance type | ||||
| Uninsured | 4.40*** (2.89, 6.71) | 7.13*** (3.67, 13.86) | 3.42*** (2.30, 5.08) | 0.75 (0.41, 1.36) |
| Public insurance | 0.78 (0.51, 1.18) | 0.77 (0.40, 1.51) | 1.07 (0.73, 1.55) | 1.69* (1.12, 2.57) |
| Private insurance (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Race/ethnicity | ||||
| Hispanic Latino | 0.89 (0.42, 1.89) | 0.18* (0.04, 0.79) | 1.34 (0.67, 2.67) | 1.13 (0.50, 2.55) |
| Non-Hispanic African American | 1.47 (0.82, 2.63) | 1.09 (0.54, 2.23) | 0.89 (0.49, 1.61) | 1.13 (0.60, 2.15) |
| Non-Hispanic American Indian | 0.46 (0.20, 1.06) | 0.02*** (0.00, 0.12) | 0.64 (0.25, 1.66) | 0.66 (0.19, 2.29) |
| Non-Hispanic Asian | 0.70 (0.29, 1.72) | 1.03 (0.26, 4.18) | 0.49 (0.20, 1.22) | 1.16 (0.50, 2.70) |
| Non-Hispanic other and multiple races | 0.72 (0.28, 1.89) | 1.25 (0.41, 3.83) | 1.31 (0.55, 3.12) | 1.77 (0.69, 4.57) |
| Non-Hispanic White (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Country of birth | ||||
| Non–US-born | 1.61 (0.90, 2.88) | 1.49 (0.61, 3.64) | 0.60 (0.34, 1.05) | 0.54 (0.28, 1.06) |
| US-born (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Age, y | ||||
| 18–25 | 3.16*** (2.01, 4.97) | 0.18*** (0.07, 0.45) | 1.63 (0.99, 2.67) | 0.95 (0.53, 1.70) |
| 26–45 | 2.19*** (1.60, 2.99) | 0.72 (0.41, 1.28) | 1.32 (0.99, 1.76) | 1.47* (1.05, 2.05) |
| 46–64 (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Family income, % of federal poverty guideline | ||||
| < 138 | 1.20 (0.76, 1.91) | 2.93** (1.33, 6.45) | 1.61* (1.04, 2.50) | 1.88** (1.23, 2.88) |
| 138–400 | 1.54* (1.10, 2.14) | 2.17** (1.21, 3.91) | 2.32*** (1.73, 3.10) | 1.10 (0.80, 1.51) |
| > 400 (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Education | ||||
| ≤ high school | 1.65** (1.16, 2.36) | 1.94* (1.04, 3.63) | 0.77 (0.54, 1.10) | 0.59* (0.39, 0.88) |
| Some college | 0.93 (0.66, 1.31) | 1.4 (0.79, 2.51) | 1.33 (0.99, 1.78) | 0.97 (0.68, 1.37) |
| ≥ college degree (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Marital status | ||||
| Unmarried | 1.25 (0.92, 1.69) | 1.00 (0.60, 1.65) | 0.78 (0.59, 1.02) | 0.91 (0.67, 1.25) |
| Married (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Employment status | ||||
| Unemployed | 0.85 (0.57, 1.25) | 0.88 (0.51, 1.52) | 1.28 (0.90, 1.81) | 0.93 (0.59, 1.46) |
| Employed (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
| Health status | ||||
| Fair or poor | 0.61* (0.37, 0.99) | 2.21** (1.30, 3.76) | 2.07*** (1.42, 3.01) | 1.72** (1.18, 2.50) |
| Excellent, very good, or good (Ref) | 1.00 | 1.00 | 1.00 | 1.00 |
Note. CI = confidence interval; OR = odds ratio. Data from the 2013 Minnesota Health Access Survey were restricted to adults aged 18–64 years who reported their own experiences of insurance-based discrimination. Data were weighted to represent the state’s population. Variables that showed significant differences in the Pearson χ2 test were included in the adjusted models.
*P < .05; **P < .01; ***P < .001.