Healthcare access, utilization, and care experiences for American Indian and Alaska Native populations.

Introduction: Despite targeted health reforms, differences in healthcare access, utilization, and mortality have persisted between American Indian and Alaska Native (AI/AN) and non-AI/AN people and within the AI/AN population. Methods: Using the 2015-2019 Medical Expenditure Panel Survey Household Component (MEPS-HC), we examined healthcare access, utilization, and care experiences for AI/AN people relative to non-AI/AN people and disaggregate the AI/AN population by race (ie, single race and one or more races) and ethnicity (ie, Hispanic and non-Hispanic). Results: We found that AI/AN people had a lower probability of at least one dental and ambulatory visit annually than non-Hispanic White people. Conversely, non-Hispanic AI/AN people were more likely than non-Hispanic White people to have at least one emergency-department (ED) visit. Non-Hispanic AI/AN people who reported multiple races had higher rates of delayed or unmet needs due to cost than non-Hispanic White people. People solely identifying as AI/AN reported worse care experiences, and non-Hispanic AI/AN people rated their healthcare lower than non-Hispanic White people. Conclusion: Our findings highlight the importance of efforts to improve healthcare access and care experiences of AI/AN people and shed light on how decisions about disaggregating race and ethnicity may affect study results.