OBJECTIVE:The purpose of this secondary data analysis was to describe racial-ethnic disparities in receipt of depression treatment and treatment modality among adult Medicaid beneficiaries with depression from a nationally representative sample-28 states and the District of Columbia-of Medicaid beneficiaries (N=599,421).
METHODS:Medicaid claims data were extracted from the full 2008-2009 Medicaid Analytic Extract file. The primary outcome was type of depression treatment: medication only, therapy only, medication and therapy, and no treatment. The secondary outcome was treatment for depression (yes-no). Crude and adjusted odds ratios (AORs) were generated for univariate and multivariate models, respectively, and 95% confidence intervals of odds ratios and p values were calculated.
RESULTS:There were 599,421 individuals in the sample. Rates of depression treatment were lower for African Americans and Hispanics, compared with Caucasians. Percentages receiving no treatment were 19.9% of African Americans, 15.2% of Hispanics, and 11.9% of Caucasians. After full adjustment, African Americans were about half as likely as Caucasians to receive treatment (AOR=0.52), Hispanics were about a third as likely (AOR=0.71), and those from other racial-ethnic groups were about a fifth as likely (AOR=0.84). Caucasians were more likely than any other group to receive medication only.
CONCLUSIONS:This study contributes to evidence about the intersection of social factors and health outcomes and discusses health care engagement, stigma, and policy drivers of racial-ethnic disparities. The study is the first to identify disparities in rates and types of depression treatment among racial-ethnic subgroups of Medicaid beneficiaries in a nationally representative sample.
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【Racial and Ethnic Disparities in Treatment and Treatment Type for Depression in a National Sample of Medicaid Recipients.].
【全国医疗补助接受者样本中抑郁症的治疗和治疗类型的种族和种族差异。】
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DOI：10.1176/appi.ps.201900407文章类型：杂志文章
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目的：本次数据分析的目的是描述来自具有全国代表性的28个州和哥伦比亚特区的医疗补助受益人中，患有抑郁症的成年医疗补助受益人在接受抑郁治疗和治疗方式方面的种族差异。 599,421）。
方法：从完整的2008-2009 Medicaid Analytic Extract提取文件中提取Medicaid索赔数据。主要结果是抑郁症治疗的类型：仅药物治疗，仅药物治疗，药物治疗和药物治疗，不接受治疗。次要结果是治疗抑郁症（是-否）。分别为单变量和多变量模型生成了原始和调整后的优势比（AOR），并计算了优势比和p值的95％置信区间。
结果：样本中有599,421个人。与高加索人相比，非洲裔美国人和西班牙裔人的抑郁症治疗率更低。未接受治疗的百分比是19.9％的非洲裔美国人，15.2％的西班牙裔美国人和11.9％的白种人。经过全面调整后，非洲裔美国人接受治疗的可能性是白种人的一半左右（AOR = 0.52），西班牙裔美国人接受治疗的可能性约为白种人的三分之一（AOR = 0.71），其他种族群体的接受治疗的可能性约为白种人（三分之一） AOR = 0.84）。高加索人比其他任何人仅接受药物治疗的可能性更高。
结论：本研究为社会因素与健康结果之间的交集提供了证据，并讨论了医疗保健的参与，污名化以及种族差异的政策驱动因素。该研究是首次在全国代表性的样本中确定医疗补助受益人的种族亚组之间的抑郁症治疗率和类型方面的差异。
方法：从完整的2008-2009 Medicaid Analytic Extract提取文件中提取Medicaid索赔数据。主要结果是抑郁症治疗的类型：仅药物治疗，仅药物治疗，药物治疗和药物治疗，不接受治疗。次要结果是治疗抑郁症（是-否）。分别为单变量和多变量模型生成了原始和调整后的优势比（AOR），并计算了优势比和p值的95％置信区间。
结果：样本中有599,421个人。与高加索人相比，非洲裔美国人和西班牙裔人的抑郁症治疗率更低。未接受治疗的百分比是19.9％的非洲裔美国人，15.2％的西班牙裔美国人和11.9％的白种人。经过全面调整后，非洲裔美国人接受治疗的可能性是白种人的一半左右（AOR = 0.52），西班牙裔美国人接受治疗的可能性约为白种人的三分之一（AOR = 0.71），其他种族群体的接受治疗的可能性约为白种人（三分之一） AOR = 0.84）。高加索人比其他任何人仅接受药物治疗的可能性更高。
结论：本研究为社会因素与健康结果之间的交集提供了证据，并讨论了医疗保健的参与，污名化以及种族差异的政策驱动因素。该研究是首次在全国代表性的样本中确定医疗补助受益人的种族亚组之间的抑郁症治疗率和类型方面的差异。
