Alegría Margarita, Alvarez Kiara, Ishikawa Rachel Zack, DiMarzio Karissa, McPeck Samantha
Margarita Alegría (
Kiara Alvarez is a postdoctoral research fellow in the Disparities Research Unit, Department of Medicine, at MGH.
Health Aff (Millwood). 2016 Jun 1;35(6):991-9. doi: 10.1377/hlthaff.2016.0029.
Despite decades of research, racial and ethnic disparities in behavioral health care persist. The Affordable Care Act expanded access to behavioral health care, but many reform initiatives fail to consider research about racial/ethnic minorities. Mistaken assumptions that underlie the expansion of behavioral health care run the risk of replicating existing service disparities. Based on a review of relevant literature and numerous observational and field studies with minority populations, we identified the following three mistaken assumptions: Improvement in health care access alone will reduce disparities, current service planning addresses minority patients' preferences, and evidence-based interventions are readily available for diverse populations. We propose tailoring the provision of care to remove obstacles that minority patients face in accessing treatment, promoting innovative services that respond to patients' needs and preferences, and allowing flexibility in evidence-based practice and the expansion of the behavioral health workforce. These proposals should help meet the health care needs of a growing racial/ethnic minority population.
尽管经过了数十年的研究,但行为健康护理方面的种族和族裔差异依然存在。《平价医疗法案》扩大了行为健康护理的可及性,但许多改革举措并未考虑关于少数种族/族裔群体的研究。行为健康护理扩张背后的错误假设,有复制现有服务差异的风险。基于对相关文献以及针对少数族裔群体的大量观察性和实地研究的回顾,我们识别出以下三个错误假设:仅改善医疗保健的可及性就能减少差异、当前的服务规划满足了少数族裔患者的偏好、基于证据的干预措施可随时用于不同人群。我们建议调整护理服务的提供方式,以消除少数族裔患者在获得治疗时面临的障碍,推广能满足患者需求和偏好的创新服务,并在基于证据的实践中允许灵活性以及扩大行为健康劳动力队伍。这些提议应有助于满足不断增长的少数种族/族裔群体的医疗保健需求。