Flaskerud J H, Hu L T
School of Nursing, University of California, Los Angeles 90024-1702.
Am J Psychiatry. 1992 Mar;149(3):379-84. doi: 10.1176/ajp.149.3.379.
The purpose of this study was to examine the relationship of racial/ethnic identity to the amount and type of psychiatric treatment received by white, black, Latino, and Asian patients in the Los Angeles County mental health system.
The patients studied (N = 19,400) consisted of all adult inpatients and outpatients seen in all county mental health facilities between January 1983 and August 1988. Multiple regression analysis was used to test the relationship between race/ethnicity and four measures of treatment received: number of treatment sessions, treatment modality, treatment setting, and therapist's discipline. The covariates included in the analyses were age, sex, socioeconomic status, primary language, diagnosis, and measures of treatment when these were logical predictors and were not acting as dependent variables.
Race/ethnicity did not have a consistent significant relationship to the treatment variables studied. However, diagnosis had a consistent and highly significant relationship to all four measures of treatment. A psychotic diagnosis was related to receiving more treatment sessions, greater use of medication, greater use of inpatient treatment, and less treatment by a professional therapist. Socioeconomic status and primary language also had consistent and significant relationships to three of the treatment variables.
In considering modifications to the service delivery system, clinicians must evaluate whether the type of treatment provided to psychotic patients is the treatment of choice in terms of effectiveness and efficiency or whether it involves bias in service delivery. Similarly, the issue of bias in treatment of lower socioeconomic patients must be addressed.
本研究旨在探讨洛杉矶县心理健康系统中白人、黑人、拉丁裔和亚裔患者的种族/族裔身份与接受的精神科治疗的数量和类型之间的关系。
所研究的患者（N = 19400）包括1983年1月至1988年8月期间在所有县心理健康机构就诊的所有成年住院患者和门诊患者。多元回归分析用于检验种族/族裔与所接受治疗的四项指标之间的关系：治疗疗程数、治疗方式、治疗环境和治疗师的专业领域。分析中纳入的协变量包括年龄、性别、社会经济地位、主要语言、诊断以及在这些因素是合理预测因素且不作为因变量时的治疗指标。
种族/族裔与所研究的治疗变量没有一致的显著关系。然而，诊断与所有四项治疗指标都有一致且高度显著的关系。精神病诊断与接受更多的治疗疗程、更多地使用药物、更多地使用住院治疗以及较少接受专业治疗师的治疗有关。社会经济地位和主要语言也与三项治疗变量有一致且显著的关系。
在考虑对服务提供系统进行调整时，临床医生必须评估为精神病患者提供的治疗类型在有效性和效率方面是否是首选治疗方法，或者它是否涉及服务提供中的偏见。同样，必须解决对社会经济地位较低患者治疗中的偏见问题。
