Racial and Ethnic Disparities in Outpatient Substance Use Disorder Treatment Episode Completion for Different Substances
Racial and Ethnic Disparities in Outpatient Substance Use Disorder Treatment Episode Completion for Different Substances
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DOI：
10.1016/j.jsat.2015.12.007
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发表时间：
2016-04-01
影响因子：
3.9
通讯作者：
Stahler, Gerald J.
中科院分区：
文献类型：
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作者：
Mennis, Jeremy;Stahler, Gerald J.
本研究调查了不同问题物质在治疗事件完成方面的种族和民族差异如何在2011年美国治疗事件数据集-出院（TEDS-D）数据集中抽取的416，224例门诊治疗出院的城市样本中发生变化。采用固定效应logistic回归检验人种和种族与不同使用物质的治疗事件完成的相关性，同时控制混杂的人口统计学、社会经济学和地理聚集因素。结果表明，非洲裔美国人和西班牙裔人完成治疗的可能性低于白人，并且这些差异在不同物质的使用者之间存在差异。对于非裔美国人来说，在所有物质上都观察到这种差异，但在酒精和甲基苯丙胺使用者中尤为严重，与白人相比，非裔美国人对这些物质的使用障碍率通常较低。对于西班牙裔人来说，这种差异主要是由海洛因使用者造成的，西班牙裔人完成治疗的可能性只有白人的75%。对于可卡因和甲基苯丙胺的使用者，西班牙裔和白人之间在完成治疗事件的可能性方面没有显著差异。这些结果有助于对物质使用障碍治疗结果机制的新兴研究，并强调需要文化上适当的治疗方案，以提高治疗方案的保留和相关的积极治疗后结果。(C)2015 Elsevier Inc. All rights reserved.
This study investigates how racial and ethnic disparities in treatment episode completion vary across different problem substances in an urban sample of 416,224 outpatient treatment discharges drawn from the 2011 U.S. Treatment Episode Dataset-Discharge (TEDS-D) data set. Fixed effects logistic regression is employed to test for the association of race and ethnicity with treatment episode completion for different substances of use while controlling for confounding demographic, socioeconomic, and geographic clustering factors. Results show that African Americans and Hispanics are less likely to complete a treatment episode than Whites, and that these disparities vary among users of different substances. For African Americans, this disparity is observed over all substances, but is particularly acute among users of alcohol and methamphetamine, substances for which African Americans generally have lower rates of use disorder as compared to Whites. For Hispanics, this disparity is driven primarily by users of heroin, for which Hispanics are only 75% as likely as Whites to complete a treatment episode. For users of cocaine and methamphetamine, there is no significant difference between Hispanics and Whites in the likelihood of treatment episode completion. These results contribute to emerging research on the mechanisms of substance use disorder treatment outcomes and highlight the need for culturally appropriate treatment programs to enhance treatment program retention and associated positive post-treatment outcomes. (C) 2015 Elsevier Inc. All rights reserved.