Disparities in mental health service use of racial and ethnic minority elderly adults.
Disparities in mental health service use of racial and ethnic minority elderly adults.
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DOI：
10.1111/jgs.12063
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发表时间：
2013-01
影响因子：
6.3
通讯作者：
Alegría M
中科院分区：
文献类型：
--
作者：
Jimenez DE;Cook B;Bartels SJ;Alegría M
我们应用医学研究所对医疗保健差异的定义来衡量精神卫生保健不同阶段的差异，并确定所使用的精神卫生服务类型的差异。合并了医疗支出小组调查第9-13小组（2004-2009）的四个两年纵向数据集。对美国各地的家庭、个人及其医疗服务提供者进行大规模调查。共有1658名（981名白人，303名黑人和374名拉丁美洲人）年龄在60岁以上的参与者可能需要精神卫生保健。Kessler-6量表评分>12分，PHQ-2量表评分>2分为精神卫生保健需要。分析了精神卫生保健事件的五个方面：1）治疗开始; 2）护理充分性; 3）护理持续时间; 4）访问次数; 5）和支出。我们评估了护理事件是否仅包括处方药填充，仅包括门诊访视，或两者兼而有之。黑人和拉丁美洲人的治疗开始和充分性低于白人。拉丁美洲人经历了更长时间的发作，访问次数增加，支出更多。黑人和拉丁美洲人的发病率明显较低，只包括药物补充。黑人只有门诊就诊的发病率显著更高。拉美裔人的药物治疗率和门诊就诊率明显更高。低心理健康治疗的启动和穷人充分表明，需要文化上适当的干预措施，使老年黑人和拉丁美洲人在精神卫生保健。在黑人（更高的门诊率）和拉丁美洲人（更高的药物治疗率加上门诊率）中的令人惊讶的发现突出了老年人人口的复杂性，并为差异研究提出了新的途径。
We apply the Institute of Medicine definition of healthcare disparities to measure disparities at different junctures of episodes of mental health care and to identify disparities in types of mental health services used. Four two-year longitudinal datasets from Panels 9–13 (2004–2009) of the Medical Expenditure Panel Surveys were combined. Large-scale surveys of families and individuals and their medical providers across the United States. A total of 1658 (981 Whites, 303 Blacks, and 374 Latinos) participants aged 60+ with probable mental health care need. Mental health care need was defined as Kessler-6 Scale >12 and PHQ-2 >2. Five aspects of mental health care episodes were analyzed: 1) treatment initiation; 2) adequacy of care; 3) duration of care; 4) number of visits; 5) and expenditures. We assessed whether episodes of care included only prescription drug fills, only outpatient visits, or both. Treatment initiation and adequacy were lower for Blacks and Latinos than Whites. Latinos experienced episodes with longer duration, increased number of visits, and more expenditures. Blacks and Latinos had significantly lower rates of episodes that consisted of only medication refills. Blacks had significantly greater rates of episodes with only outpatient care visits. Latinos had significantly higher rates of medication plus outpatient visits. Low mental health treatment initiation and poor adequacy suggest the need for culturally appropriate interventions to engage older Blacks and Latinos in mental health care. The surprising findings among Blacks (greater rates of outpatient care visits) and Latinos (higher rates of medication plus outpatient visits) highlight the complexities of the older adult population and suggest new avenues for disparities research.
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影响因子：
6.3
作者：
Jimenez DE;Alegría M;Chen CN;Chan D;Laderman M
通讯作者：
Laderman M
影响因子：
2.3
作者：
Conner, Kyaien O.;Lee, Brenda;Brown, Charlotte
通讯作者：
Brown, Charlotte
影响因子：
7.2
作者：
Jimenez, Daniel E.;Bartels, Stephen J.;Alegria, Margarita
通讯作者：
Alegria, Margarita
影响因子：
3.8
作者：
Alegria, Margarita;Chatterji, Pinka;Meng, Xiao-Li
通讯作者：
Meng, Xiao-Li
影响因子：
3
作者：
Blanco, Carlos;Patel, Sapana R.;Olfson, Mark
通讯作者：
Olfson, Mark