Trends in Racial-Ethnic Disparities in Access to Mental Health Care, 2004-2012
Trends in Racial-Ethnic Disparities in Access to Mental Health Care, 2004-2012
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DOI：
10.1176/appi.ps.201500453
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发表时间：
2017-01-01
影响因子：
3.8
通讯作者：
Progovac, Ana M.
中科院分区：
文献类型：
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作者：
Le Cook, Benjamin;Nhi-Ha Trinh;Progovac, Ana M.
目标：本研究比较了白人、黑人、西班牙裔和亚洲人在精神卫生保健获得方面的种族-民族差异趋势，使用医学研究所对差异的定义，即除了临床适当性、临床需要和患者偏好以外的所有差异。通过使用来自全国代表性样本214人的数据，2004-2012年医疗支出小组调查的597名成年人。主要结果的措施，包括三个精神卫生保健的访问措施（使用任何精神卫生保健，任何门诊治疗，并在过去一年的任何精神药物）。结果：显着差异，发现在2004-2005年和2011-2012年的所有三个种族-少数民族群体与白人相比，在所有三个措施的访问。2004年至2012年期间，任何精神卫生保健和任何精神药物使用的黑人-白人差异分别从8.2%增加到10.8%和从7.6%增加到10.0%。同样，西班牙裔白人在任何精神卫生保健和任何精神药物使用方面的差异分别从8.4%增加到10.9%和7.3%增加到10.3%.Conclusions：2004年至2012年期间，在获得精神卫生保健方面的种族-民族差异没有减少。在此期间，黑人和西班牙裔人的差异加剧。改善精神疾病症状识别的临床干预措施、扩大医疗保险以及消除获得医疗服务的财政障碍的其他政策干预措施可能有助于减少这些差距。
Objective: This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences.Methods: Racial-ethnic disparities in mental health care access were examined by using data from a nationally representative sample of 214,597 adults from the 2004-2012 Medical Expenditure Panel Surveys. The main outcome measures included three mental health care access measures (use of any mental health care, any outpatient care, and any psychotropic medication in the past year).Results: Significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access. Between 2004 and 2012, black-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.2% to 10.8% and from 7.6% to 10.0%. Similarly, Hispanic-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.4% to 10.9% and 7.3% to 10.3%.Conclusions: No reductions in racial-ethnic disparities in access to mental health care were identified between 2004 and 2012. For blacks and Hispanics, disparities were exacerbated over this period. Clinical interventions that improve identification of symptoms of mental illness, expansion of health insurance, and other policy interventions that remove financial barriers to access may help to reduce these disparities.