Health Care Access and Perceptions of Provider Care among Individuals in

Same-Sex Couples

Joseph Clift

AHRQ/Environmental Protection Agency

James Kirby

AHRQ

Background

Most research on LGBT people focuses on health disparities, not access, use or perceptions

Most research is based on small, convenience samples

Objective

Compare individuals in same-sex couples to those in different-sex married couples– Access– Preventive Use– Perceptions of care

Method

Descriptive statistics with difference tests corrected for the complex sample design

Logistic regression models controlling for a limited number of basic sociodemographic variables– Age, household income, highest degree,

metropolitan residence and insurance status

Data

Medical Expenditure Panel Survey, pooled for 1996-2007

Sample: individuals who are married or who report having a “partner” of the same sex – 136,676 married individuals– 696 individuals in same sex couples

Variables

Access

Preventive Use

Perceptions of Provider Care

Results: Access

Has USC Got appt when wanted (urgent)

Got appt when wanted

(non-urgent)

Easy to see a specialist

0%

10%

20%

30%

40%

50%

60%

70%

80%

90% 83% 85% 84%77%

81% 79%74%

62%

Different-sex married Same-sex

*

*

Results: Access

Unable to get dental care

Delayed in getting dental care

Unable to get Rx Delays in getting Rx

0%

1%

2%

3%

4%

5%

6%

7%

3% 3%

2%

3%

4%

5%

2%

6%

Different-sex married Same-sex

*

Results: Preventive Use

Had routine checkup

Had flu shot Had blood pressure checked

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

65%

32%

84%

64%

39%

83%

Different-sex married Same-sex

*

Results: Perceptions of Provider Care

Clear explanations provided

Provider showed respect

Provider spent enough time

74%76%78%80%82%84%86%88%90%92%94% 93% 93%

87%

90%88%

80%

Different-sex married Same-sex

*

Odds-ratios from Logistic regression model

VariableDifferent-

sexSame-

sex

Got medical appointment when wanted (urgent) 1.0 0.8

Got medical appointment when wanted (non-urgent) 1.0 0.6

Easy to see a specialist 1.0 0.6

Delayed in getting necessary prescription drugs 1.0 2.4

Had flu shot in last year 1.0 1.7

Doctor showed respect 1.0 0.6

Doctor spent enough time 1.0 0.7

*

*

*

*

*

*

Summary and Conclusions

Statistically significant differences exist on:– Timeliness of getting appointments and Rx drugs– Ease in seeing specialists– Annual flu shot

Most measures show no statistically significant difference

Overall pattern of differences indicate that individuals in same-sex couples have generally worse access and more negative perceptions of care– Annual flu shot is the exception

Limitations

Cannot infer to LGBT people, only to those in same-sex cohabiting couples

Differences are “averages” over 12 years

Descriptive