National trends in ethnic disparities in mental health care
National trends in ethnic disparities in mental health care
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DOI：
10.1097/mlr.0b013e3180ca95d3
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发表时间：
2007-11-01
期刊：
影响因子：
3
通讯作者：
Olfson, Mark
中科院分区：
文献类型：
--
作者：
Blanco, Carlos;Patel, Sapana R.;Olfson, Mark
目的：为了比较西班牙裔和非西班牙裔之间的精神疾病的办公室为基础的治疗的趋势。设计，设置和参与者：1993年和2002年之间进行的访问办公室为基础的医生（N = 251,905）的全国代表性样本的分析。随访分为1993-1996年、1997-1999年和2000- 2002年三个独立的时间段。主要指标：诊断率、心理健康随访类型、接受的治疗类型（药物或心理治疗）、精神药物处方率和治疗医生的专业。从1993-1996年到2000-2002年，西班牙裔美国人接受精神卫生保健的比例从12.2%下降到11.7%，而非西班牙裔美国人从13.1%上升到15.7%（P < 0.05）。西班牙裔的精神障碍就诊率从5.2%下降到5.1%，而非西班牙裔的精神障碍就诊率从6.0%上升到8.8%（P < 0.05）。在西班牙裔中，导致精神药物处方的就诊率从10.2%下降到9.3%，而在非西班牙裔中，这一比例从10.2%上升到12.5%（P < 0.05）。西班牙裔的心理治疗就诊率从2.4%下降到1.3%（P < 0.05），而非西班牙裔的心理治疗就诊率保持不变（2.5%）。西班牙裔的精神科医生就诊率从2.5%下降到1.3%（P < 0.05），而非西班牙裔的精神科医生就诊率从3.1%上升到3.5%（无显著性）。大多数差异持续调整后的年龄和保险status.Conclusions：从1993年至2002年，有一个增加的精神卫生保健之间的差距西班牙裔和非西班牙裔的办公室为基础的医生治疗。改善拉美裔人的精神卫生保健仍然是一个重要的公共卫生优先事项，卫生保健政策制定者和从业人员面临着明显的机遇和挑战。
Objective: To compare trends in office-based treatment of mental disorders between Hispanics and non-Hispanics.Design, Setting, and Participants: Analysis of a nationally representative sample of visits to office-based physicians conducted between 1993 and 2002 (N = 251,905). Visits were grouped into 3 discrete time periods, 1993-1996, 1997-1999 and 2000-2002.Main Outcome Measures: Rate of diagnosis, type of mental health visit, type of treatment received (medication or psychotherapy), rate of psychotropic medications prescription, and specialty of the treating physician.Results: From 1993-1996 to 2000-2002, the proportion of office visits in which mental health care was provided decreased for Hispanics from 12.2% to 11.7% while it increased from 13.1% to 15.7% for non-Hispanics (P < 0.05). Visits with a diagnosis of mental disorder decreased from 5.2% to 5.1% in Hispanics but increased from 6.0% to 8.8% in non-Hispanics (P < 0.05). Visits resulting in prescription of a psychotropic medication decreased from 10.2% to 9.3% in Hispanics, while they increased from 10.2% to 12.5% in non-Hispanics (P < 0.05). Psychotherapy visits decreased from 2.4% to 1.3% in Hispanics (P < 0.05), whereas they remained constant (2.5%) in non-Hispanics. Visits to a psychiatrist decreased from 2.5% to 1.3% in Hispanics (P < 0.05), while they increased (nonsignificantly) from 3.1% to 3.5% for non-Hispanics. Most differences persisted after adjusting for age and insurance status.Conclusions: From 1993 to 2002, there was an increase in mental health care disparities between Hispanics and non-Hispanics treated by office-based physicians. Improvement of the mental health care for Hispanics continues to be an important public health priority, with clear opportunities and challenges for health care policymakers and practitioners.