Baylor Scott & White Health, Center for Applied Health Research, Central Texas Veterans Health Care System, Temple, TX, USA.
Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA, USA.
Depress Anxiety. 2017 Dec;34(12):1157-1163. doi: 10.1002/da.22696. Epub 2017 Nov 2.
There are many limitations with the evidence base for the role of race and ethnicity in continuation of psychotherapy for depression.
The study sample consisted of 242,765 patients ≥ 18 years old from six healthcare systems in the Mental Health Research Network (MHRN) who had a new episode of psychotherapy treatment for depression between 1/1/2010 and 12/31/2013. Data were from electronic medical records and organized in a Virtual Data Warehouse (VDW). The odds of racial and ethnic minority patients returning for a second psychotherapy visit within 45 days of the initial session were examined using multilevel regression.
The sample was primarily middle aged (68%, 30-64 years old), female (68.5%), and non-Hispanic white (50.7%), had commercial insurance (81.4%), and a low comorbidity burden (68.8% had no major comorbidities). Return rates within 45 days of the first psychotherapy visit were 47.6%. Compared to their non-Hispanic white counterparts, racial and ethnic minority patients were somewhat less likely to return to psychotherapy for a second visit (adjusted odds ratios [aORs] ranged from 0.80 to 0.90). Healthcare system was a much stronger predictor of return rates (aORs ranged from 0.89 to 5.53), while providers accounted for 21.1% of the variance in return rates.
Provider and healthcare system variation were stronger predictors of patient return to psychotherapy than race and ethnicity. More research is needed to understand why providers and healthcare systems determine psychotherapy return rates for patients of all racial and ethnic groups.
种族和民族在继续接受抑郁症心理治疗中的作用的证据基础存在许多局限性。
研究样本由心理健康研究网络（MHRN）的六个医疗保健系统中的 242765 名年龄≥18 岁的患者组成，他们在 2010 年 1 月 1 日至 2013 年 12 月 31 日期间接受了新的心理治疗治疗。数据来自电子病历，并在虚拟数据仓库（VDW）中进行了组织。使用多层回归检查少数民族和少数族裔患者在初始治疗后 45 天内再次接受心理治疗的可能性。
该样本主要为中年（68%，30-64 岁），女性（68.5%）和非西班牙裔白人（50.7%），有商业保险（81.4%），合并症负担较低（68.8%无主要合并症）。第一次心理治疗就诊后 45 天内的复诊率为 47.6%。与非西班牙裔白人相比，少数民族患者再次接受心理治疗的可能性略低（调整后的优势比[ORs]范围为 0.80 至 0.90）。医疗保健系统是复诊率的更强预测因素（ORs 范围为 0.89 至 5.53），而提供者占复诊率差异的 21.1%。
提供者和医疗保健系统的差异是患者回归心理治疗的更强预测因素，而种族和民族则不然。需要进一步研究以了解为什么提供者和医疗保健系统决定所有种族和族裔患者的心理治疗复诊率。
