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完成门诊物质使用障碍治疗需要多长时间?美国黑人和西班牙裔与白人之间的差异。

How long does it take to complete outpatient substance use disorder treatment? Disparities among Blacks, Hispanics, and Whites in the US.

机构信息

Department of Geography and Urban Studies, Temple University, Philadelphia, PA, United States.

Department of Geography and Urban Studies, Temple University, Philadelphia, PA, United States.

出版信息

Addict Behav. 2019 Jun;93:158-165. doi: 10.1016/j.addbeh.2019.01.041. Epub 2019 Jan 28.

Abstract

This research investigates racial and ethnic disparities in outpatient substance use disorder treatment completion and duration in treatment, for different substances, across the US, using the national 2014 Treatment Episode Dataset-Discharge (TEDS-D) data set. Moderated fixed effects logistic regression models assessed effects of race/ethnicity on length of stay in treatment and treatment completion for different substances of use. Moderated models also assessed the differential effect of length of stay on treatment completion among Blacks, Hispanics, and Whites. While Blacks and Hispanics both have significantly lower treatment completion rates than Whites, treatment duration is substantially similar across the three groups. Blacks and Hispanics generally take longer to complete treatment than Whites, though this varies by substance for Hispanics. Disparities in treatment completion persist even after controlling for treatment duration. These results indicate that observed racial and ethnic disparities in treatment completion are not due to differences in length of stay in treatment. Economic, cultural, accessibility, or, potentially, discriminatory, factors may suppress the likelihood of treatment completion for minorities and result in longer treatment durations required for completion. Recognition by treatment providers of the unique challenges to treatment completion faced by minorities may enhance treatment outcomes for minorities in the US.

摘要

本研究利用美国全国 2014 年治疗期数据集中的治疗出院数据集(TEDS-D),调查了不同种族和民族在门诊物质使用障碍治疗完成率和治疗持续时间方面的差异,以及不同物质的治疗情况。采用调节固定效应逻辑回归模型评估了种族/民族对不同物质使用的治疗持续时间和治疗完成率的影响。调节模型还评估了治疗持续时间对黑人和西班牙裔以及白人治疗完成率的差异影响。虽然黑人及西班牙裔的治疗完成率均显著低于白人,但三组之间的治疗持续时间基本相似。黑人及西班牙裔完成治疗的时间通常比白人长,尽管西班牙裔在不同物质方面的差异有所不同。即使在控制治疗持续时间后,治疗完成方面的差异仍然存在。这些结果表明,治疗完成方面观察到的种族和民族差异并非由于治疗持续时间的差异所致。经济、文化、可及性或潜在的歧视因素可能会抑制少数族裔完成治疗的可能性,并导致完成治疗所需的时间延长。治疗提供者认识到少数族裔在完成治疗方面面临的独特挑战,可能会提高美国少数族裔的治疗效果。

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