Document Detail


Racial and ethnic disparities in use of psychotherapy: evidence from U.S. national survey data.
MedLine Citation:
PMID:  20360275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study investigated racial and ethnic disparities in psychotherapy use and expenditures in the United States and identified important factors associated with these disparities. METHODS: Using the Medical Expenditure Panel Survey from 1996 to 2006, the investigators performed bivariate and multivariable analyses to estimate racial and ethnic disparities in the probability of receiving any psychotherapy, total psychotherapy expenditures, and out-of-pocket-payment share for 7,376 patients with depressive or anxiety disorders. Blinder-Oaxaca decomposition techniques were used to identify the most important factors associated with these disparities. RESULTS: Caucasians were more likely to use psychotherapy than Latinos (57% versus 52%, p<.001), but there was no significant difference between Caucasians and African Americans in the probability of receiving any psychotherapy. Caucasians self-paid 29% of the total cost for each visit, significantly higher than the shares paid by Latinos (19%) and African Americans (14%). Racial-ethnic differences in the propensity to utilize psychotherapy vanished in multivariable regression, but Caucasians still paid a significantly higher out-of-pocket share than others. English proficiency was the most important factor associated with racial-ethnic disparities in psychotherapy use. The extensive Medicaid coverage among Latinos and African Americans was the main reason for their lower out-of-pocket payment for psychotherapy compared with Caucasians. CONCLUSIONS: This study found little evidence of racial and ethnic disparities in access to psychotherapy services. Health care reforms affecting mental health coverage under Medicaid would significantly affect psychotherapy expenditure and use among Latinos and African Americans.
Authors:
Jie Chen; John Rizzo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Psychiatric services (Washington, D.C.)     Volume:  61     ISSN:  1557-9700     ISO Abbreviation:  Psychiatr Serv     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-06-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502838     Medline TA:  Psychiatr Serv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  364-72     Citation Subset:  IM    
Affiliation:
Department of Political Science, Economics, and Philosophy, College of Staten Island, City University of New York, 2N-229, 2800 Victory Blvd., Staten Island, NY 10314, USA. jie.chen@csi.cuny.edu
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MeSH Terms
Descriptor/Qualifier:
African Americans / psychology*,  statistics & numerical data*
Anxiety Disorders / economics,  ethnology*,  therapy*
Costs and Cost Analysis
Depressive Disorder / economics,  ethnology*,  therapy*
European Continental Ancestry Group / psychology*,  statistics & numerical data*
Financing, Personal / statistics & numerical data
Health Expenditures / statistics & numerical data
Healthcare Disparities / economics,  utilization*
Hispanic Americans / psychology*,  statistics & numerical data*
Humans
Medicaid / economics,  utilization
Multivariate Analysis
Psychotherapy / economics,  statistics & numerical data*
United States
Utilization Review / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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