Department of Psychiatry, Vagelos College of Physicians & Surgeons Columbia University and New York State Psychiatric Institute, New York, New York.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
J Clin Psychiatry. 2023 Jul 26;84(5):22m14661. doi: 10.4088/JCP.22m14661.
To describe associations between patient race and ethnicity with emergency department disposition for mental health visits in the United States. We identified 674,821 visits for mental health in the 2019 National Emergency Department Sample and classified them by diagnostic group: schizophrenia-spectrum, bipolar, major depressive, anxiety, or other disorders. Racial and ethnic categories were White, Black, Hispanic, or other. Logistic regression models, adjusted for age, sex, insurance status, and medical comorbidities, were used to describe differences in odds of inpatient admission by race/ethnicity and diagnosis. After covariate adjustment, we did not find overall differences in the likelihood of admission between racial/ethnic groups. However, compared to White patients, admission rates were lower for visits by Black patients for bipolar disorder (OR = 0.71; 95% CI, 0.59-0.84) and major depressive disorder (OR = 0.70; 95% CI, 0.59-0.83) and lower for Hispanic patients (OR = 0.57; 95% CI, 0.47-0.68) for anxiety disorders. There were no significant racial/ethnic differences in admission rates for schizophrenia-spectrum disorders. Overall admission rates were comparable for Black and White patients. After covariate adjustment, there were no differences across racial/ethnic groups, though some racial/ethnic differences persisted within diagnostic subsets of mood and anxiety disorders.
描述美国急诊就诊患者的种族和民族与心理健康就诊处置之间的关联。我们在 2019 年国家急诊抽样调查中识别出 674821 例心理健康就诊,并根据诊断组别进行分类:精神分裂症谱系、双相情感障碍、重度抑郁、焦虑或其他障碍。种族和民族类别为白人、黑人、西班牙裔或其他。使用逻辑回归模型,调整年龄、性别、保险状况和合并症,描述种族/民族和诊断对住院入院几率的差异。在调整协变量后,我们没有发现不同种族/民族之间入院几率存在总体差异。然而,与白人患者相比,黑人患者的双相情感障碍(OR=0.71;95%CI,0.59-0.84)和重度抑郁障碍(OR=0.70;95%CI,0.59-0.83)就诊的入院率较低,西班牙裔患者的焦虑障碍就诊的入院率也较低(OR=0.57;95%CI,0.47-0.68)。精神分裂症谱系障碍的入院率在不同种族/民族之间没有显著差异。黑人患者和白人患者的总体入院率相当。在调整协变量后,不同种族/民族之间没有差异,但在情绪和焦虑障碍的诊断亚组中,一些种族/民族差异仍然存在。