Mark Olfson1, Donald K Cherry, Roberto Lewis-Fernández. 1. Department of Psychiatry, Division of Epidemiology, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, New York, NY 10032, USA. mo49@columbia.edu
Abstract
CONTEXT: Substantial racial disparities exist in the delivery of some health care services. Whether racial disparities exist in the duration of office visits to psychiatrists is not known. OBJECTIVE: To compare the duration of visits to office-based psychiatrists by white and African American patients. DESIGN, SETTING, AND PARTICIPANTS: Analysis of a nationally representative sample of visits to office-based psychiatrists between 2001 and 2006. Visits were grouped by patient race as non-Hispanic African American (n = 504) or non-Hispanic white (n = 7094). Main Outcome Measure Duration of face-to-face contact between patient and psychiatrist. RESULTS: Unadjusted mean duration of psychiatric outpatient visits by African Americans (mean duration, 28.3 minutes) were 4.4 minutes shorter than visits by whites (32.7 minutes) (P = .02), although the difference narrowed (3.5 minutes; P = .07) following adjustment for potentially confounding patient, psychiatrist, and practice characteristics. A gap was evident in 2001-2003 (7.4 minutes; P <.001) but negligible in 2004-2006 (0.1 minute; P = .94). In stratified regressions that combined time periods and controlled for several relevant characteristics, significant racial differences in visit duration were observed among visits with the following characteristics: adjustment disorder diagnosis (10.0 minutes; P <.001), female patient sex (5.4 minutes; P = .008), depressive disorder diagnosis (5.2 minutes; P = .04), solo practice (5.2 minutes; P = .04), psychotherapy provision (5.1 minutes; P = .01), practices with high patient volume (5.0 minutes; P = .03), Medicare payment (3.5 minutes; P = .02), and absence of psychiatric comorbidity (3.3 minutes; P = .04). CONCLUSIONS: In recent years, progress has been made in closing a racial gap in the length of psychiatric office-based outpatient visits by African American vs white patients. Against a backdrop of persisting racial disparities in other areas of mental health care, ongoing attention to reducing disparities will be necessary to sustain and extend these gains.
CONTEXT: Substantial racial disparities exist in the delivery of some health care services. Whether racial disparities exist in the duration of office visits to psychiatrists is not known. OBJECTIVE: To compare the duration of visits to office-based psychiatrists by white and African American patients. DESIGN, SETTING, AND PARTICIPANTS: Analysis of a nationally representative sample of visits to office-based psychiatrists between 2001 and 2006. Visits were grouped by patient race as non-Hispanic African American (n = 504) or non-Hispanic white (n = 7094). Main Outcome Measure Duration of face-to-face contact between patient and psychiatrist. RESULTS: Unadjusted mean duration of psychiatricoutpatient visits by African Americans (mean duration, 28.3 minutes) were 4.4 minutes shorter than visits by whites (32.7 minutes) (P = .02), although the difference narrowed (3.5 minutes; P = .07) following adjustment for potentially confounding patient, psychiatrist, and practice characteristics. A gap was evident in 2001-2003 (7.4 minutes; P <.001) but negligible in 2004-2006 (0.1 minute; P = .94). In stratified regressions that combined time periods and controlled for several relevant characteristics, significant racial differences in visit duration were observed among visits with the following characteristics: adjustment disorder diagnosis (10.0 minutes; P <.001), female patient sex (5.4 minutes; P = .008), depressive disorder diagnosis (5.2 minutes; P = .04), solo practice (5.2 minutes; P = .04), psychotherapy provision (5.1 minutes; P = .01), practices with high patient volume (5.0 minutes; P = .03), Medicare payment (3.5 minutes; P = .02), and absence of psychiatric comorbidity (3.3 minutes; P = .04). CONCLUSIONS: In recent years, progress has been made in closing a racial gap in the length of psychiatric office-based outpatient visits by African American vs white patients. Against a backdrop of persisting racial disparities in other areas of mental health care, ongoing attention to reducing disparities will be necessary to sustain and extend these gains.
Authors: Brady G Case; David N Bertollo; Eugene M Laska; Carole E Siegel; Joseph A Wanderling; Mark Olfson Journal: J Affect Disord Date: 2011-12-12 Impact factor: 4.839
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Authors: Margarita Alegría; Evette Ludman; E Nilay Kafali; Sheri Lapatin; Doriliz Vila; Patrick E Shrout; Kristen Keefe; Benjamin Cook; Andrea Ault; Xinliang Li; Amy M Bauer; Claudia Epelbaum; Carmela Alcantara; Tulia I G Pineda; Gloria G Tejera; Gloria Suau; Karla Leon; Anna S Lessios; Rafael R Ramirez; Glorisa Canino Journal: Med Care Date: 2014-11 Impact factor: 2.983