Knudsen Hannah K, Roman Paul M
University of Kentucky.
Sociol Focus. 2009;42:133-151. doi: 10.1080/00380237.2009.10571347.
Most analyses of racial and ethnic disparities in healthcare focus on individuals rather than organizations. Healthcare organizations may be one mechanism that produces disparities if the representation of minorities within organizations' patient populations is associated with differential patterns of service delivery. This research considers whether the racial and ethnic composition of addiction treatment centers' caseloads is associated with the likelihood that organizations offer any prescription medications to treat addiction, psychiatric conditions, or pain. Data were collected from 288 publicly-funded substance abuse treatment centers in the US. Logistic regression was used to estimate models of medication availability. The percentage of racial and ethnic minority patients was negatively associated with the odds of medication availability, even after controlling for organizational characteristics and patients' diagnostic characteristics. Future research should continue to investigate how healthcare organizations may produce inequalities in access to high-quality care.
大多数关于医疗保健中种族和民族差异的分析都侧重于个体而非组织。如果组织患者群体中的少数群体代表性与不同的服务提供模式相关,那么医疗保健组织可能是产生差异的一种机制。本研究探讨成瘾治疗中心病例负荷的种族和民族构成是否与组织提供任何用于治疗成瘾、精神疾病或疼痛的处方药的可能性相关。数据收集自美国288家由公共资金资助的药物滥用治疗中心。采用逻辑回归来估计药物可及性模型。即使在控制了组织特征和患者的诊断特征之后,种族和少数民族患者的百分比与药物可及性的几率呈负相关。未来的研究应继续调查医疗保健组织如何可能在获得高质量护理方面产生不平等。