Jung Kyoungrae, Lim Dooyoung, Shi Yunfeng
Psychiatr Serv. 2014 Sep 1;65(9):1140-6. doi: 10.1176/appi.ps.201300182.
The objective of this study was to examine racial-ethnic disparities in the use of antidepressants among people with private coverage and people with public insurance or no coverage.
Data were from Medical Expenditure Panel Surveys (2006-2010), and logistic regression was used for the analysis.
Among persons with depression and private coverage, racial-ethnic minority groups were significantly less likely than non-Hispanic whites to use antidepressants (N=4,468; adjusted odds ratio [AOR]=.50, 95% confidence interval [CI]=.33-.66 for non-Hispanic blacks; AOR=.70, CI=.55-.89 for Hispanics). No significant racial-ethnic disparity in the use of antidepressants was found in Medicare (N=1,944), Medicaid (N=2,125), and uninsured populations (N=1,679). For all racial-ethnic groups, persons with no insurance coverage had much lower rates of antidepressant use than their insured counterparts.
A wide racial-ethnic gap in the use of antidepressants existed in private coverage. As the nation continues to implement the Affordable Care Act, which will increase the number of enrollees from racial-ethnic minority groups in private plans, continuing efforts will be needed to reduce racial-ethnic disparities in the use of antidepressants.
本研究旨在调查享有私人保险者、享有公共保险者或无保险者在使用抗抑郁药方面的种族和民族差异。
数据来自医疗支出面板调查（2006 - 2010年），并采用逻辑回归进行分析。
在患有抑郁症且享有私人保险的人群中，种族和民族少数群体使用抗抑郁药的可能性明显低于非西班牙裔白人（N = 4468；非西班牙裔黑人的调整优势比[AOR] = 0.50，95%置信区间[CI] = 0.33 - 0.66；西班牙裔的AOR = 0.70，CI = 0.55 - 0.89）。在医疗保险人群（N = 1944）、医疗补助人群（N = 2125）和未参保人群（N = 1679）中，未发现使用抗抑郁药方面存在显著的种族和民族差异。对于所有种族和民族群体，未参保者使用抗抑郁药的比例远低于参保者。
在私人保险覆盖人群中，使用抗抑郁药方面存在很大的种族和民族差距。随着国家继续实施《平价医疗法案》，这将增加私人保险计划中种族和民族少数群体的参保人数，因此需要持续努力以减少在使用抗抑郁药方面的种族和民族差异。
