Provider Contributions to Disparities in Mental Health Care
| Autor: | John E. Zeber, Greg Simon, Tae Yoon, Christine Stewart, Karen J. Coleman, Brian K. Ahmedani, Yihe G. Daida, Scott A. Baldwin, Beth Waitzfelder, Zac E. Imel, Samuel Hubley, Arne Beck, Rebecca C. Rossom, Kritzia Merced, Heidi Fischer |
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| Rok vydání: | 2020 |
| Předmět: |
Mental Health Services
Washington Gerontology Treatment adherence media_common.quotation_subject education California Article 03 medical and health sciences fluids and secretions 0302 clinical medicine parasitic diseases Ethnicity Humans Psychology Quality (business) 030212 general & internal medicine Healthcare Disparities Physician's Role Minority Groups media_common Psychiatry Mental Disorders Bayes Theorem Mental health 030227 psychiatry body regions Psychiatry and Mental health Mental health care Cultural competence |
| Zdroj: | Psychiatr Serv |
| ISSN: | 1557-9700 1075-2730 |
| DOI: | 10.1176/appi.ps.201800500 |
| Popis: | Disparities in diagnosis of mental health problems and in access to treatment among racial-ethnic groups are apparent across different behavioral conditions, particularly in the quality of treatment for depression. This study aimed to determine how much disparities differ across providers.Bayesian mixed-effects models were used to estimate whether disparities in patient adherence to antidepressant medication (N=331,776) or psychotherapy (N=275,095) were associated with specific providers. Models also tested whether providers who achieved greater adherence to treatment, on average, among non-Hispanic white patients than among patients from racial-ethnic minority groups attained lower disparities and whether the percentage of patients from racial-ethnic minority groups in a provider caseload was associated with disparities.Disparities in adherence to both antidepressant medication and psychotherapy were associated with the provider. Provider performance with non-Hispanic white patients was negatively correlated with provider-specific disparities in adherence to psychotherapy but not to antidepressants. A higher proportion of patients from racial-ethnic minority groups in a provider's caseload was associated with lower adherence among non-Hispanic white patients, lower disparities in adherence to psychotherapy, and greater disparities in adherence to antidepressant medication.Adherence to depression treatment among a provider's patients from racial-ethnic minority groups was related to adherence among that provider's non-Hispanic white patients, but evidence also suggested provider-specific disparities. Efforts among providers to decrease disparities might focus on improving the general skill of providers who treat more patients from racial-ethnic minority groups as well as offering culturally based training to providers with notable disparities. |
| Databáze: | OpenAIRE |
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