Scheffler R M, Miller A B
Inquiry. 1989 Summer;26(2):202-15.
This paper estimates demand for mental health services by blacks, Hispanics, and whites, as well as males and females, using a three-part regression model. It examines the probability of mental health use and the level of outpatient and inpatient use. The data base is the high option Blue Cross/Blue Shield Federal Employee Health Benefits Plan for the 1979 to 1981 period. All user subpopulations sharing this plan have the same coverage, so differences in demand and utilization are related to ethnic and racial background, age, salary, outpatient visit copayment and market area characteristics, including the supply of psychiatrists. Results show vast differences in demand for care by ethnic, racial, and gender groups with identical insurance coverage. Alternative explanations for the differences are suggested.
本文使用三部分回归模型估计了黑人、西班牙裔和白人以及男性和女性对心理健康服务的需求。它考察了使用心理健康服务的概率以及门诊和住院服务的使用水平。数据库是1979年至1981年期间的高选项蓝十字/蓝盾联邦雇员健康福利计划。所有共享该计划的用户亚群体都有相同的保险范围,因此需求和利用率的差异与种族和民族背景、年龄、工资、门诊就诊自付费用以及市场区域特征(包括精神科医生的供应)有关。结果表明,在拥有相同保险范围的情况下,不同种族、民族和性别的群体在护理需求上存在巨大差异。文中还提出了对这些差异的其他解释。