The Grand Challenge of Reducing Gender and Racial/Ethnic Disparities in Service Access and Needs Among Adults with Alcohol Misuse.
The Grand Challenge of Reducing Gender and Racial/Ethnic Disparities in Service Access and Needs Among Adults with Alcohol Misuse.
复制标题
减少酗酒成年人在服务获取和需求方面的性别和种族/民族差异的巨大挑战。
DOI：
10.1080/1533256x.2017.1302887
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发表时间：
2017
影响因子：
0.8
通讯作者：
Manuel,JenniferI
中科院分区：
文献类型：
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作者：
Manuel,JenniferI
本研究探讨了《平价医疗法案》（ACA）对获得和使用行为健康服务方面的性别、种族和民族差异的影响，这些差异发生在报告重度或酗酒（n = 52，496）和酒精使用障碍（AUD; n = 22，966）的全国成年人样本中。差异中的差异模型估计了医疗保健改革之前（2008-2009年）和之后（2011-2014年）与服务相关的差异。在全面实施ACA之前（2011-2013年）和之后（2014年）进行了亚组分析。由于细胞大小不足，重度或狂欢饮酒的受访者中的亚洲亚组被排除在物质使用障碍（SUD）治疗和未满足需求结局模型之外。在重度或酗酒者中，未满足的SUD治疗需求在黑人女性中减少，在黑人男性中增加。亚裔男性的心理健康（MH）治疗减少，而西班牙裔男性未满足的MH治疗需求减少。在患有AUD的西班牙裔女性中，MH治疗增加。虽然黑人和西班牙裔妇女和西班牙裔男子在使用和获得服务方面有所改善，但黑人和亚裔男子却遇到了挫折。社会工作者的影响进行了讨论。
This study examined the impact of the Affordable Care Act (ACA) on gender and racial and ethnic disparities in accessing and using behavioral health services among a national sample of adults who reported heavy or binge alcohol use (n = 52,496) and those with alcohol use disorder (AUD; n = 22,966). Difference-in-differences models estimated service-related disparities before (2008–2009) and after (2011–2014) health care reform. A subanalysis was conducted before (2011–2013) and after (2014) full implementation of the ACA. Asian subgroups among respondents with heavy or binge drinking were excluded from substance use disorder (SUD) treatment and unmet need outcome models due to insufficient cell size. Among heavy or binge drinkers, unmet SUD treatment need decreased among Black women and increased among Black men. Mental health (MH) treatment decreased among Asian men, whereas unmet MH treatment need decreased among Hispanic men. MH treatment increased among Hispanic women with AUD. Although there were improvements in service use and access among Black and Hispanic women and Hispanic men, there were setbacks among Black and Asian men. Implications for social workers are discussed.