Rosales Robert, Calvo Rocío
Department of Behavioral & Social Sciences, Center for Alcohol and Addictions Studies, Brown University School of Public Health, 121 South Main Street, 4th Floor, Providence, RI, 02903, USA.
Boston College, School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
BMC Health Serv Res. 2021 Feb 28;21(1):186. doi: 10.1186/s12913-021-06198-6.
The Patient Protection and Affordable Care Act increased funding for integrated care to improve access to quality health care among underserved populations. There is evidence that integrated care decreases inequities in access and quality of mental health care among Hispanic clients. Increasing integrated care at Hispanic-Serving Organizations may help to eliminate mental health service disparities among Hispanic clients.
Using organizational responses from the 2014 and 2016 waves of the National Mental Health Service survey, this study conducted multivariate logistic analyses to assess whether the ACA policies related to integrated care increased the provision of integrated addictions treatment and primary care at mental health Hispanic-Serving Organizations, relative to Mainstream Organizations.
Findings showed that Hispanic-Serving Organizations (54.4%) were less likely to provide integrated health services than Mainstream Organizations (59.1%) after the ACA. However, federal funding to help organizations transition into integrated care services (AOR = 1.74, p = 0.01) and accepting Medicaid payments (AOR = 1.59, p = 0.01) increased the provision of integrated care services at Hispanic-Serving Organizations over time.
Health care policies that increase funding to adopt integrated health services at community Hispanic-Serving Organizations may help decrease inequities in mental health access for Hispanics in the United States.
《患者保护与平价医疗法案》增加了对综合医疗的资金投入，以改善弱势群体获得优质医疗服务的机会。有证据表明，综合医疗减少了西班牙裔客户在获得心理健康护理的机会和质量方面的不平等现象。在为西班牙裔服务的组织中增加综合医疗服务可能有助于消除西班牙裔客户之间的心理健康服务差距。
本研究利用2014年和2016年全国心理健康服务调查的组织回复，进行多变量逻辑分析，以评估与综合医疗相关的《平价医疗法案》政策相对于主流组织，是否增加了为西班牙裔服务的心理健康组织提供综合成瘾治疗和初级保健的服务。
研究结果显示，在《平价医疗法案》实施后，为西班牙裔服务的组织（54.4%）比主流组织（59.1%）提供综合健康服务的可能性更小。然而，随着时间的推移，用于帮助组织过渡到综合护理服务的联邦资金（调整后比值比=1.74，p=0.01）和接受医疗补助付款（调整后比值比=1.59，p=0.01）增加了为西班牙裔服务的组织提供综合护理服务的比例。
增加资金以在社区为西班牙裔服务的组织中采用综合健康服务的医疗政策，可能有助于减少美国西班牙裔在获得心理健康服务方面的不平等现象。
