School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
Am J Public Health. 2013 Sep;103(9):1628-33. doi: 10.2105/AJPH.2013.301238. Epub 2013 Jul 18.
We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities.
Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences.
When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities.
Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.
通过与社区组织签订合同来实施语言援助计划，以改善西班牙裔英语水平有限的医疗保险参保者获得心理健康服务的可及性，并减少基于语言的治疗机会差异，本研究旨在调查这种方式的实施程度。
使用时间序列非等效对照组设计，我们研究了在 10 年（1997-2006 年）期间西班牙语英语水平有限的医疗保险参保者的语言援助计划在县级的普及程度。我们使用带县固定效应的线性回归来控制持续趋势和其他影响。
当县心理健康计划与社区组织签订合同时，与其他计划相比，实施语言援助计划的计划增加了西班牙语心理健康服务在 Medi-Cal 下的普及率（0.28 个百分点，平均增长 25%；P<.05）。然而，增加的幅度不足以显著减少与语言相关的差距。
由社区组织运营的心理健康治疗计划在实施所需的语言援助计划后，可能会适度改善获得服务的机会，但该计划并未减少心理健康服务获取方面的固有差距。
