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首页> 外文期刊>Health services research: HSR >Racial/ethnic disparities in specialty behavioral health care treatment patterns and expenditures among commercially insured patients in managed behavioral health care plans
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Racial/ethnic disparities in specialty behavioral health care treatment patterns and expenditures among commercially insured patients in managed behavioral health care plans

机译：特种行为医疗保健治疗模式和商业保险患者的种族/民族差异在管理行为保健计划中的商业保险患者

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Objective To document differences among racial/ethnic/gender groups in specialty behavioral health care (BH) utilization/expenditures; examine whether these differences are driven by probability vs intensity of treatment; and identify whether differences are explained by socioeconomic status (SES). Data Source The cohort consists of adults continuously enrolled in Optum plans with BH benefits during 2013. Study Design We modeled each outcome using linear regressions among the entire sample stratified by race/ethnicity, language and gender. Then, we estimated logistic regressions of the probability that an enrollee had any spending/use in a given service category (service penetration) and linear regressions of spending/use among the user subpopulation (treatment intensity). Lastly, all analyses were rerun with SES controls. Data Collection This study links administrative data from a managed BH organization to a commercial marketing database. Principal Findings We found that in many cases, racial/ethnic minorities had lower specialty BH expenditures/utilization, relative to whites, primarily driven by differences in service penetration. Among women, relative to whites, Asian non-English speakers, Asian English speakers, Hispanic non-English speakers, Hispanic English speakers, and blacks had $106, $95, $90, $48, and $61 less in total expenditures. SES explained racial/ethnic differences in treatment intensity but not service penetration. Conclusions In this population, SES was not a major driver of racial/ethnic differences in specialty BH utilization. Future studies should explore the role of other factors not studied here, such as stigma, cultural competence, and geography.
机译：目的介绍特种行为医疗保健（BH）利用/支出中的种族/民族/性别群体的差异;检查这些差异是否受到概率对治疗强度的驱动;并确定社会经济地位是否解释了差异。数据源队列由2013年持续参加Optum计划的成年人组成。研究设计我们在种族/民族，语言和性别分类的整个样本中使用线性回归建模了每个结果。然后，我们估计登记者在给定的服务类别（服务渗透率）中有任何支出/使用的概率的逻辑回归和用户亚群之间的支出/使用的线性回归（治疗强度）。最后，所有分析都re rerun与ses控制。数据收集本研究将管理数据从管理的BH组织联系到商业营销数据库。主要发现我们发现在许多情况下，种族/少数民族的特种BH支出/利用率较低，相对于白人，主要由服务渗透率的差异驱动。在妇女中，相对于白人，亚洲非英语发言者，亚洲英语发言者，西班牙裔非英语发言者，西班牙裔英语扬声器和黑人的英语扬声器和黑人在总支出中的106美元，95美元，90美元，48美元和61美元。 SES解释了治疗强度的种族/民族差异，但不提供服务渗透。在这个人口中，SES不是特种BH利用的种族/民族差异的主要司机。未来的研究应该探讨这里没有研究过的其他因素的作用，例如耻辱，文化能力和地理。

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